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Minnesota rates for HCPCS L5150

Knee disarticulation (or through knee), molded socket, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,328.35 / $4,328.35 / $4,328.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,935.29 / $3,839.99 / $4,328.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,426.72 / $5,167.59 / $7,195.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,134.07 / $4,909.21 / $5,167.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,249.00 / $15,944.48 / $44,284.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,990.63 / $6,350.06 / $7,608.09
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,466.04 / $15,297.95 / $34,869.65
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,990.63 / $5,990.63 / $6,164.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,398.23 / $5,167.59 / $22,345.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,401.84 / $2,348.08 / $5,189.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,401.84 / $2,470.44 / $8,759.61