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Minnesota rates for HCPCS L4000

Replace Girdle For Spinal Orthotic (Cervic-Thoracic-Lumbar-Sacor

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,106.25 / $1,106.25 / $1,106.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.81 / $1,106.25 / $1,185.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,363.87 / $1,592.13 / $2,216.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,273.70 / $1,512.52 / $1,592.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$897.58 / $4,912.04 / $13,642.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,845.75 / $1,956.50 / $2,344.10
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,916.22 / $4,712.85 / $10,742.35
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,845.75 / $1,845.75 / $1,899.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$476.53 / $1,592.13 / $7,517.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.75 / $794.29 / $1,757.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.27 / $957.27 / $957.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.75 / $794.29 / $1,598.78