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North Dakota rates for HCPCS L5697

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Band

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.39 / $76.39 / $76.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.39 / $94.05 / $94.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.17 / $116.07 / $118.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.13 / $131.43 / $165.26
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.19 / $94.05 / $510.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.83 / $72.09 / $84.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.64 / $73.56 / $83.65