go back

Idaho rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $257 · 10th–90th $141–$3550%20%10th90th$257Professionalmedian $186 · 10th–90th $100–$3240%10%10th90th$186$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $173.78 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $275.42 / $467.74
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $323.59 / $323.59
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $141.25
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $223.87 / $295.12
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $281.84 / $295.12
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $251.19
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $281.84 / $281.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $309.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $295.12 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $162.18 / $165.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $109.65 / $165.96