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Minnesota rates for HCPCS L5643

Addition to lower extremity, hip disarticulation, flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,230.27 / $2,041.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,398.83 / $3,548.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,398.83 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $8,912.51 / $21,877.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $3,162.28 / $3,548.13
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $8,912.51 / $16,982.44
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $3,801.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $2,398.83 / $4,466.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,000.00 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.79 / $1,230.27 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,071.52 / $2,818.38