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Minnesota rates for HCPCS L5624

Addition To Lower Extremity Test Socket Above Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.69 / $403.69 / $403.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.36 / $384.26 / $403.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$412.87 / $481.97 / $671.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.58 / $457.87 / $481.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.77 / $1,486.65 / $4,129.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.75 / $592.28 / $709.61
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.61 / $1,426.37 / $3,251.21
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.75 / $558.75 / $574.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.76 / $481.97 / $2,310.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $243.55 / $483.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $230.41 / $483.97