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Minnesota rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $72.44 / $114.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.90 / $138.04 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $138.04 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $512.86 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $181.97 / $204.17
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $512.86 / $977.24
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $158.49 / $218.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.18 / $138.04 / $245.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $60.26 / $134.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.98 / $79.43 / $165.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $67.61 / $162.18