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Idaho rates for HCPCS L5676

Additions to lower extremity, below knee (BK), knee joints, single axis, pair

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.16 / $425.92 / $482.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.77 / $271.77 / $363.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.39 / $271.77 / $289.72
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.08 / $380.76 / $537.91
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.02 / $481.36 / $506.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $373.93 / $445.33
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.67 / $494.81 / $742.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.68 / $369.88 / $532.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.62 / $216.98 / $343.56