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Minnesota rates for HCPCS L5613

Addition To Lower Extremity Endoskeletal System Above Knee- Knee Disarticulation 4 Bar Linkage With Hydraulic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,463.73 / $2,463.73 / $2,463.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,388.23 / $2,463.73 / $2,682.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,519.73 / $2,941.43 / $4,095.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,353.14 / $2,794.36 / $2,941.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.78 / $9,076.11 / $25,208.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,409.88 / $3,614.47 / $4,330.54
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,388.38 / $8,708.08 / $19,848.91
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,409.88 / $3,409.88 / $3,509.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$975.78 / $2,941.43 / $15,444.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.30 / $1,543.51 / $3,164.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.30 / $1,467.45 / $3,164.28