go back

Idaho rates for HCPCS L5698

Addition to lower extremity, above knee (AK) or knee disarticulation, Silesian bandage

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.09 / $126.15 / $136.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.25 / $99.25 / $103.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.45 / $72.45 / $131.46
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.32 / $112.68 / $150.07
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.06 / $142.57 / $150.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $110.74 / $131.90
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.41 / $146.55 / $219.83
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.05 / $105.05 / $157.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.10 / $0.10 / $93.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.75 / $62.46 / $100.29