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Idaho rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,029.66 / $1,423.12 / $1,423.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,061.83 / $1,232.20 / $1,232.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $1,232.20 / $1,313.59
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.20 / $1,192.52 / $1,692.97
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,523.67 / $1,608.32 / $1,692.97
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $1,249.40 / $1,487.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,482.42 / $1,653.29 / $2,479.94
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.08 / $1,185.08 / $1,777.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.86 / $740.73 / $1,174.79