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Idaho rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.39 / $422.09 / $422.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.54 / $274.54 / $285.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.41 / $200.41 / $456.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.13 / $376.97 / $502.13
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.92 / $477.02 / $502.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $370.57 / $441.32
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$439.68 / $490.36 / $735.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.49 / $351.49 / $527.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.71 / $217.07 / $344.28