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North Dakota rates for HCPCS L5631

Addition to lower extremity, above knee (AK) or knee disarticulation, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.68 / $383.68 / $383.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.68 / $441.72 / $441.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.09 / $583.00 / $597.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.25 / $617.36 / $776.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$294.02 / $422.84 / $2,777.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.10 / $394.64 / $438.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.40 / $321.36 / $438.49