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Minnesota rates for HCPCS L5642

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686.76 / $686.76 / $686.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.44 / $686.76 / $721.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.37 / $819.92 / $1,141.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$655.94 / $778.92 / $819.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.41 / $2,529.46 / $7,025.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.63 / $1,007.66 / $1,207.29
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,501.72 / $2,426.91 / $5,531.81
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.63 / $950.63 / $978.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.69 / $819.92 / $3,873.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.32 / $414.27 / $823.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.32 / $395.00 / $823.35