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North Dakota rates for HCPCS L4030

Replace quadrilateral socket brim, custom fitted

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.82 / $413.82 / $413.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.82 / $513.29 / $513.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$531.83 / $628.80 / $644.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$856.50 / $865.07 / $1,087.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.12 / $513.29 / $3,084.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.60 / $315.04 / $472.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.18 / $307.12 / $472.94