go back

North Dakota rates for HCPCS L5696

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Joint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.57 / $161.57 / $161.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.57 / $198.04 / $198.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.64 / $245.50 / $251.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.13 / $276.87 / $348.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.64 / $198.04 / $1,184.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.47 / $166.19 / $184.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.31 / $355.31 / $355.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.86 / $166.19 / $184.65