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North Dakota rates for HCPCS L1755

Legg Perthes orthosis, (Patten bottom type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,297.70 / $1,297.70 / $1,297.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,297.70 / $1,498.95 / $1,498.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,667.73 / $1,971.85 / $2,020.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.88 / $2,525.88 / $3,176.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$827.78 / $1,498.95 / $9,370.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.59 / $896.88 / $1,483.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.24 / $896.88 / $1,483.09