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Idaho rates for HCPCS L5728

Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,888.38 / $2,610.00 / $3,167.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,050.41 / $2,050.41 / $2,388.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,496.80 / $1,496.80 / $3,609.74
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$919.83 / $2,378.63 / $3,437.85
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,794.40 / $2,949.65 / $3,104.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $2,291.40 / $2,728.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,718.75 / $3,032.12 / $4,548.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,173.42 / $2,266.57 / $3,260.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,317.35 / $1,424.81 / $2,259.73