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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
$399.18 / $551.72 / $551.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$411.21 / $493.58 / $493.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.31 / $493.58 / $526.19
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.31 / $492.73 / $656.33
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.70 / $623.51 / $656.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $484.37 / $576.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.71 / $640.95 / $961.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.43 / $459.43 / $689.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.95 / $285.49 / $452.79