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Idaho rates for HCPCS L8415

Prosthetic sheath, upper limb, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.82 / $27.39 / $27.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $16.30 / $18.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.91 / $16.30 / $17.39
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.27 / $23.91 / $32.58
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.32 / $30.95 / $32.58
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.48 / $24.34 / $30.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.53 / $31.82 / $47.73
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.81 / $22.81 / $34.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.87 / $12.83 / $21.77