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Minnesota rates for HCPCS L5638

Addition to lower extremity, below knee (BK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$652.33 / $652.33 / $652.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.33 / $566.62 / $652.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$667.15 / $778.81 / $1,084.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.04 / $739.87 / $778.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.81 / $2,403.26 / $6,674.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.00 / $957.18 / $1,146.81
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,426.79 / $2,305.81 / $5,255.79
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$903.00 / $903.00 / $929.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.77 / $772.35 / $3,083.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.27 / $326.02 / $782.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.77 / $388.77 / $388.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.27 / $326.02 / $802.17