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Minnesota rates for HCPCS L5637

Addition To Lower Extremity Below Knee Total Contact

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$387.24 / $387.24 / $387.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.21 / $305.33 / $387.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$396.04 / $462.31 / $643.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.85 / $439.19 / $462.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.98 / $1,426.64 / $3,962.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.88 / $568.03 / $680.56
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$846.98 / $1,368.80 / $3,119.99
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.88 / $535.88 / $551.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.03 / $462.31 / $1,951.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.32 / $230.64 / $464.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.44 / $230.64 / $720.60