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Idaho rates for HCPCS L5642

Addition To Lower Extremity Above Knee Leather Socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.03 / $833.47 / $833.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$466.42 / $530.41 / $530.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.20 / $387.20 / $1,041.08
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.50 / $698.42 / $991.51
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.36 / $941.93 / $991.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $731.73 / $871.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$868.20 / $968.27 / $1,452.41
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$694.06 / $694.06 / $1,041.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.01 / $370.99 / $588.38