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Minnesota rates for HCPCS L5220

Above Knee Short Prosthesis No Knee Joint (Stubbies) With Articulated Ankle/Foot Dynamically Aligned Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,214.82 / $3,214.82 / $3,214.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,520.07 / $2,915.30 / $3,214.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,287.89 / $3,838.15 / $5,344.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,070.52 / $3,646.24 / $3,838.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,482.86 / $11,842.49 / $32,891.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,449.75 / $4,716.74 / $5,651.18
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,030.75 / $11,362.29 / $25,898.84
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,449.75 / $4,449.75 / $4,578.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,098.24 / $3,838.15 / $17,674.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,101.07 / $1,844.30 / $3,854.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.38 / $2,182.50 / $2,202.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,101.07 / $1,834.88 / $3,854.21