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Minnesota rates for HCPCS 21175

Rcnstj Bifrontal Superior-Lat Orb Rims & Lwr Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,178.83 / $2,178.83 / $6,781.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,001.22 / $2,190.62 / $3,470.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,610.82 / $13,180.74 / $23,682.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,819.04 / $6,155.43 / $7,802.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,247.13 / $7,444.91 / $17,909.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,928.78 / $6,258.45 / $9,294.76
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,770.10 / $6,806.44 / $14,102.16
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,556.99 / $5,597.39 / $8,523.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,229.53 / $3,695.13 / $6,500.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,393.52 / $4,245.66 / $8,832.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,940.00 / $6,787.00 / $11,165.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,393.52 / $3,950.48 / $8,379.61