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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
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $7.08 / $10.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $12.30 / $18.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $12.30 / $12.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $45.71 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $16.22 / $18.20
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $45.71 / $87.10
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $14.13 / $15.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.37 / $12.30 / $33.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.55 / $5.25 / $13.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $4.79 / $7.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $5.89 / $15.14