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Minnesota rates for HCPCS L5520

Preparatory, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, direct formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,096.48 / $1,584.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $1,905.46 / $2,818.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $7,079.46 / $16,982.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,511.89 / $2,818.38
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $6,918.31 / $13,489.63
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $3,019.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,905.46 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $870.96 / $2,290.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.80 / $1,148.15 / $2,344.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $954.99 / $2,238.72