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North Dakota rates for HCPCS L5647

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$848.12 / $848.12 / $848.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.69 / $799.69 / $848.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,089.96 / $1,288.71 / $1,320.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,107.00 / $1,118.07 / $1,405.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.01 / $848.12 / $5,050.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$396.93 / $714.47 / $928.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.41 / $629.41 / $629.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.54 / $714.47 / $1,133.13