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North Dakota 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
$1,255.76 / $1,255.76 / $1,255.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.76 / $1,596.14 / $1,596.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,613.82 / $1,908.10 / $1,955.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,209.13 / $2,231.21 / $2,805.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$962.29 / $1,450.90 / $9,329.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$687.62 / $1,291.64 / $1,435.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.05 / $1,291.64 / $1,435.15