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Minnesota rates for HCPCS L5647

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$799.69 / $799.69 / $799.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438.38 / $799.69 / $848.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$817.87 / $954.75 / $1,329.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$763.80 / $907.01 / $954.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$596.58 / $2,945.36 / $8,180.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,107.00 / $1,173.42 / $1,405.89
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.63 / $2,825.93 / $6,441.34
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,107.00 / $1,107.00 / $1,138.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.73 / $954.75 / $5,050.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.54 / $531.88 / $1,027.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.61 / $629.41 / $635.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.54 / $501.00 / $1,241.18