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Idaho rates for HCPCS L5859

Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,018.54 / $15,229.13 / $15,229.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $9,812.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,340.66 / $9,812.54 / $10,106.92
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,501.68 / $15,229.13 / $18,116.77
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,305.09 / $17,210.93 / $18,116.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,863.68 / $17,692.16 / $26,538.24
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,681.74 / $12,681.74 / $19,022.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,301.45 / $7,834.36 / $14,039.11