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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
$2,758.78 / $2,758.78 / $2,758.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,326.18 / $2,467.36 / $2,758.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,821.48 / $3,293.69 / $4,586.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,634.95 / $3,129.01 / $3,293.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $10,162.37 / $28,225.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,818.25 / $4,047.35 / $4,849.18
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,033.29 / $9,750.31 / $22,224.54
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,818.25 / $3,818.25 / $3,929.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$925.39 / $3,293.69 / $14,630.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$927.78 / $1,554.04 / $3,307.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$927.78 / $1,554.04 / $3,307.46