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North Dakota rates for HCPCS L5100

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,754.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,659.59 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $3,090.30 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $4,786.30
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $2,754.23 / $14,791.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,380.38 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $4,570.88 / $4,570.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $2,089.30 / $3,548.13