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Idaho rates for HCPCS L5646

Addition to lower extremity, below knee (BK), air, fluid, gel or equal, cushion socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.15 / $591.75 / $591.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$410.92 / $410.92 / $412.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.97 / $410.92 / $438.06
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$211.80 / $547.04 / $703.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.55 / $668.76 / $703.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $519.51 / $618.71
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.41 / $687.46 / $1,031.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.77 / $513.89 / $739.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.33 / $328.08 / $520.33