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Minnesota rates for HCPCS L5611

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with friction swing phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,619.75 / $1,619.75 / $1,619.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.92 / $1,619.75 / $1,875.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,656.56 / $1,933.80 / $2,692.74
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,547.04 / $1,837.11 / $1,933.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,226.77 / $5,966.25 / $16,570.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,241.75 / $2,376.26 / $2,847.02
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,542.09 / $5,724.32 / $13,047.84
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,241.75 / $2,241.75 / $2,306.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$641.51 / $1,933.80 / $10,120.69
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.16 / $1,027.20 / $2,085.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.16 / $964.75 / $1,960.09