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Idaho rates for HCPCS L5637

Addition to lower extremity, below knee (BK), total contact

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.33 / $300.37 / $383.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.98 / $232.98 / $288.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.08 / $232.98 / $273.20
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.68 / $268.54 / $357.32
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.58 / $339.45 / $357.32
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $263.70 / $314.06
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.89 / $348.95 / $523.42
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.12 / $250.12 / $375.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.94 / $172.98 / $276.91