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Minnesota rates for HCPCS L5677

Additions To Lower Extremity Below Knee Knee Joints Polycentric Pair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$557.92 / $557.92 / $557.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.72 / $521.13 / $557.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.61 / $666.10 / $927.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.88 / $632.79 / $666.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.78 / $2,055.65 / $5,709.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$772.13 / $818.45 / $980.60
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,220.42 / $1,953.22 / $4,495.59
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$772.13 / $772.13 / $794.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.32 / $666.10 / $3,128.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.82 / $329.68 / $668.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.16 / $530.74 / $1,267.05