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Minnesota rates for HCPCS L5622

Addition To Lower Extremity Test Socket Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.85 / $403.85 / $403.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.79 / $383.18 / $403.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$413.03 / $482.15 / $671.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.72 / $458.04 / $482.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.54 / $1,487.68 / $4,131.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.13 / $592.66 / $710.09
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$883.22 / $1,427.36 / $3,253.48
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.13 / $559.13 / $575.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.34 / $482.15 / $2,359.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.72 / $240.54 / $484.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.72 / $242.40 / $484.17