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Idaho rates for HCPCS L5650

Additions to lower extremity, total contact, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$418.94 / $579.03 / $649.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.03 / $379.03 / $490.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $276.69 / $820.31
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.72 / $517.12 / $688.82
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.94 / $654.38 / $688.82
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $508.35 / $605.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$603.16 / $672.68 / $1,009.02
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.17 / $502.84 / $723.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.27 / $292.32 / $463.62