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Idaho rates for HCPCS L5620

Addition to lower extremity, test socket, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.53 / $299.27 / $299.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.59 / $209.59 / $220.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $209.59 / $223.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.47 / $267.29 / $356.02
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.42 / $338.22 / $356.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $262.74 / $312.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.75 / $347.68 / $521.52
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.21 / $249.21 / $373.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.27 / $249.71 / $256.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.91 / $166.47 / $264.02