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Minnesota rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $2,754.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,659.59 / $2,754.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,311.31 / $4,786.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $12,302.69 / $29,512.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $4,365.16 / $4,897.79
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $12,302.69 / $23,442.29
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $5,248.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $3,311.31 / $5,888.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,380.38 / $3,467.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $1,819.70 / $3,801.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,584.89 / $3,801.89