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Idaho rates for HCPCS L5647

Addition to lower extremity, below knee (BK), suction socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.66 / $802.57 / $1,058.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$596.58 / $596.58 / $798.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.50 / $435.50 / $1,224.02
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.50 / $753.36 / $1,147.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.28 / $907.01 / $954.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $704.60 / $839.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$836.01 / $932.37 / $1,398.56
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.33 / $696.97 / $1,002.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $714.47 / $733.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.39 / $476.31 / $739.85