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Idaho rates for HCPCS L5643

Addition To Lower Extremity Hip Disarticulation Flexible Inner Socket External Frame

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,304.31 / $1,802.74 / $1,802.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,167.30 / $1,167.30 / $1,171.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $1,167.30 / $1,244.40
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.66 / $1,611.63 / $2,144.55
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,930.10 / $2,037.32 / $2,144.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $1,582.68 / $1,884.86
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,877.85 / $2,094.29 / $3,141.44
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,501.19 / $1,565.52 / $2,251.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.69 / $931.98 / $1,478.11