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North Dakota rates for HCPCS L5642

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$721.37 / $721.37 / $721.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.83 / $686.76 / $721.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$927.06 / $1,096.10 / $1,123.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.63 / $960.13 / $1,207.29
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.79 / $721.37 / $3,873.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.09 / $556.48 / $790.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.32 / $556.48 / $882.57