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Idaho rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $398.11 / $549.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $630.96 / $954.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $741.31 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $489.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $549.54 / $707.95
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $630.96 / $676.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $562.34
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $645.65 / $645.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $741.31
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $676.08 / $676.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $380.19 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $288.40 / $436.52