go back

North Dakota rates for HCPCS L5250

Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,623.41 / $5,754.40 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $3,715.35 / $5,754.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,456.54 / $8,709.64 / $9,549.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,762.47 / $7,762.47 / $9,772.37
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $6,456.54 / $33,113.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $3,890.45 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $10,232.93 / $10,232.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $4,677.35 / $7,762.47