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North Dakota rates for HCPCS L5695

Addition To Lower Extremity Above Knee Pelvic Control Sleeve Suspension Neoprene Or Equal Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.13 / $173.13 / $173.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.94 / $163.94 / $173.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.50 / $263.08 / $269.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.88 / $229.14 / $288.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.13 / $173.13 / $1,037.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.38 / $146.47 / $192.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.09 / $118.72 / $189.60