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North Dakota rates for HCPCS L5301

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,021.49 / $2,021.49 / $2,021.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,021.49 / $2,709.06 / $2,709.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,597.90 / $3,071.63 / $3,148.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,749.63 / $3,787.12 / $4,762.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,449.25 / $2,709.06 / $14,785.52
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,106.92 / $2,062.25 / $2,910.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,409.26 / $4,409.26 / $4,409.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.56 / $1,386.16 / $2,291.39