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Idaho rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.59 / $1,138.31 / $1,138.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.38 / $702.38 / $849.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.74 / $702.38 / $748.77
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.03 / $953.87 / $1,354.15
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,218.74 / $1,286.44 / $1,354.15
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $999.36 / $1,190.17
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.74 / $1,322.41 / $1,983.62
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.91 / $947.91 / $1,421.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.48 / $560.78 / $904.80