go back

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
$7,762.47 / $10,964.78 / $15,135.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,135.61 / $17,378.01 / $26,302.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,498.45 / $20,417.38 / $20,417.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $9,772.37 / $9,772.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,317.64 / $8,317.64 / $9,772.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,481.54 / $15,488.17 / $21,877.62
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,135.61 / $17,378.01 / $18,620.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,378.01 / $17,782.79 / $17,782.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,882.50 / $12,882.50 / $20,417.38
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,454.40 / $18,620.87 / $18,620.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,471.29 / $11,748.98 / $11,748.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,244.36 / $7,762.47 / $12,302.69