go back

Minnesota rates for HCPCS L5694

Addition To Lower Extremity Above Knee Pelvic Control Belt Padded And Lined

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.38 / $182.38 / $182.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.98 / $182.38 / $182.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.53 / $217.74 / $303.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.19 / $206.85 / $217.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.85 / $671.42 / $1,864.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.38 / $267.52 / $320.52
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.62 / $644.20 / $1,468.36
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.38 / $252.38 / $259.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.23 / $217.74 / $1,167.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.42 / $114.26 / $234.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.42 / $108.63 / $232.46