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Minnesota rates for HCPCS L5671

Addition to lower extremity, below knee (BK)/above knee (AK) suspension locking mechanism (shuttle, lanyard, or equal), excludes socket insert

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.06 / $500.06 / $500.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.16 / $500.06 / $579.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.43 / $597.02 / $831.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$477.62 / $567.16 / $597.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.63 / $1,842.53 / $5,117.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.25 / $733.79 / $879.16
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,093.89 / $1,767.82 / $4,029.51
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.25 / $692.25 / $712.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.05 / $593.69 / $3,301.32
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.56 / $333.23 / $642.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.56 / $496.41 / $1,053.74