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Idaho rates for HCPCS L5830

Addition Endoskeletal Knee-Shin System Single Axis Pneumatic/ Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,656.99 / $2,484.25 / $2,526.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,654.54 / $1,654.54 / $1,904.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.81 / $1,654.54 / $1,763.81
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$733.52 / $2,116.26 / $2,955.30
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,659.77 / $2,807.54 / $2,955.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $2,181.01 / $2,597.44
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,587.76 / $2,886.04 / $4,329.06
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,068.71 / $2,068.71 / $3,103.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,050.53 / $1,136.22 / $1,802.04