go back

Idaho rates for HCPCS L5656

Addition To Lower Extremity Socket Insert Knee Disarticulation (Kemblo Pelite Aliplast Plastazote Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.27 / $499.02 / $499.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.84 / $335.84 / $372.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.16 / $245.16 / $482.41
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.40 / $418.16 / $593.64
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.28 / $563.96 / $593.64
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $438.10 / $521.75
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$519.80 / $579.72 / $869.58
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.55 / $415.55 / $623.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.37 / $222.12 / $396.66