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Idaho rates for HCPCS L5974

All lower extremity prostheses, foot, single axis ankle/foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.33 / $313.48 / $313.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.77 / $174.77 / $233.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.58 / $174.77 / $186.32
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.08 / $262.68 / $372.93
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.64 / $354.28 / $372.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $275.22 / $327.76
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$326.54 / $364.18 / $546.27
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.05 / $261.05 / $391.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.01 / $139.54 / $249.17