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Minnesota rates for HCPCS L5617

Addition to lower extremity, quick change self-aligning unit, above knee (AK) or below knee (BK), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$565.75 / $565.75 / $565.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.81 / $534.75 / $565.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$578.61 / $675.45 / $940.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.36 / $641.67 / $675.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.96 / $2,083.58 / $5,786.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.00 / $829.98 / $994.41
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,237.00 / $1,999.10 / $4,556.68
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.00 / $783.00 / $805.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.45 / $675.45 / $3,169.20
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.97 / $338.30 / $678.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.97 / $338.81 / $788.25