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North Dakota rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,429.22 / $4,429.22 / $4,429.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,020.77 / $4,821.74 / $4,821.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,692.19 / $6,730.17 / $6,897.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,673.50 / $6,740.24 / $8,475.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,189.94 / $4,507.22 / $24,371.76
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,172.40 / $3,416.83 / $4,850.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,518.59 / $3,416.83 / $4,850.68