go back

Minnesota rates for HCPCS L5683

Addition To Lower Extremity Below Knee/Above Knee Custom Fabricated Socket Insert For Other Than Congenital Or Atypical Traumatic Amputee Siliconegel Elastomeric Or Equal For Use With Or Without Locking Mechanism Initial Only(For Other Than I Nitial Use Code L5673 Or L5679)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,330.08 / $1,330.08 / $1,330.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.08 / $1,249.51 / $1,330.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,360.31 / $1,587.98 / $2,211.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,270.38 / $1,508.58 / $1,587.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.52 / $4,899.63 / $13,608.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.88 / $1,951.33 / $2,337.91
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,908.85 / $4,700.95 / $10,715.20
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.88 / $1,840.88 / $1,894.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.71 / $1,587.98 / $7,396.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.92 / $791.97 / $1,733.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.92 / $790.47 / $1,635.62