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Idaho rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$610.92 / $844.39 / $844.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.20 / $572.20 / $584.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $572.20 / $589.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.19 / $754.14 / $1,004.49
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$904.04 / $954.27 / $1,004.49
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $741.31 / $882.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$879.57 / $980.95 / $1,471.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.14 / $716.31 / $1,054.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.01 / $382.88 / $671.18