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Idaho rates for HCPCS L5855

Addition Endoskeletal System Hip Disarticulation Mechanical Hip Extension Assist

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.58 / $415.46 / $415.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.78 / $239.78 / $309.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.04 / $239.78 / $246.97
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.39 / $348.14 / $494.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$444.81 / $469.52 / $494.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $364.74 / $434.39
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.77 / $482.65 / $723.98
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.96 / $345.96 / $518.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.02 / $247.02 / $247.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.98 / $184.93 / $330.23