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Idaho rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $112.20 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $177.83 / $275.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $208.93 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $100.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$51.29 / $154.88 / $218.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $181.97 / $190.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $162.18
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $181.97 / $181.97
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $134.90 / $208.93
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $190.55 / $190.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $107.15 / $120.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $79.43 / $123.03