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North Dakota rates for HCPCS L5624

Addition to lower extremity, test socket, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.45 / $318.45 / $318.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.45 / $403.69 / $403.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.27 / $483.90 / $495.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.75 / $564.34 / $709.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.28 / $380.01 / $2,310.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.38 / $326.54 / $362.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $326.54 / $362.82