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Idaho rates for HCPCS L5987

All lower extremity prostheses, shank foot system with vertical loading pylon

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,155.18 / $7,125.19 / $7,125.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,316.39 / $6,042.00 / $6,042.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,410.66 / $6,042.00 / $7,085.17
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,498.65 / $5,970.68 / $8,476.20
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,628.59 / $8,052.40 / $8,476.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $6,255.44 / $7,449.80
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,422.07 / $8,277.54 / $12,416.33
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,933.35 / $6,145.72 / $8,900.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,578.48 / $3,870.38 / $6,138.39