go back

Idaho rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.99 / $320.63 / $320.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.25 / $248.05 / $248.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.08 / $248.05 / $264.43
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.85 / $268.69 / $381.43
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.29 / $362.36 / $381.43
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $281.49 / $335.24
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.99 / $372.49 / $558.74
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.00 / $267.00 / $400.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.94 / $190.30 / $295.58