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Idaho rates for HCPCS L5652

Addition to lower extremity, suction suspension, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.26 / $439.87 / $439.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.21 / $338.50 / $338.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.11 / $338.50 / $360.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.53 / $368.60 / $523.28
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.95 / $497.12 / $523.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $386.17 / $459.92
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.20 / $511.02 / $766.53
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.30 / $381.99 / $549.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.37 / $261.06 / $405.50