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Minnesota rates for HCPCS A5114

Leg strap; foam or fabric, replacement only, per set

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.89 / $7.89 / $7.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.38 / $7.89 / $9.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.66 / $13.20 / $17.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.90 / $11.96 / $12.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.51 / $38.28 / $106.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.25 / $15.11 / $18.10
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.73 / $36.72 / $83.71
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.25 / $14.25 / $14.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.52 / $12.37 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $5.89 / $13.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $5.89 / $12.42