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Idaho rates for HCPCS L5795

Addition Exoskeletal System Hip Disarticulation Ultra-Light Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.77 / $1,083.28 / $1,114.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.11 / $908.11 / $908.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $662.92 / $1,353.12
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.05 / $907.76 / $1,288.69
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,159.82 / $1,224.26 / $1,288.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $951.05 / $1,132.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,128.42 / $1,258.48 / $1,887.72
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$902.08 / $902.08 / $1,353.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.42 / $642.91 / $998.63