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North Dakota 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
$1,812.18 / $1,812.18 / $1,812.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,645.06 / $2,025.61 / $2,025.61
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,328.90 / $2,753.58 / $2,822.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,803.50 / $2,831.54 / $3,560.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$879.67 / $1,812.18 / $9,793.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.62 / $1,397.97 / $1,984.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.32 / $1,397.97 / $1,984.61