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Idaho rates for HCPCS L5828

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,061.42 / $2,849.16 / $3,652.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.90 / $2,117.90 / $2,753.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,546.07 / $1,546.07 / $4,002.01
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,091.64 / $2,637.10 / $3,811.44
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,050.47 / $3,219.94 / $3,389.41
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $2,501.38 / $2,978.97
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,967.88 / $3,309.97 / $4,964.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,372.59 / $2,474.27 / $3,558.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,563.41 / $1,690.94 / $2,626.53