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Idaho rates for HCPCS L5706

Custom Shaped Protective Cover Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.31 / $1,001.10 / $1,001.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$746.96 / $957.73 / $957.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.14 / $957.73 / $1,020.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.30 / $838.89 / $1,190.91
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.82 / $1,131.35 / $1,190.91
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $878.89 / $1,046.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,042.81 / $1,163.00 / $1,744.50
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$833.64 / $833.64 / $1,250.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$595.23 / $595.23 / $595.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$504.55 / $545.71 / $865.48