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Minnesota rates for HCPCS L5701

Replacement Socket Above Knee/Knee Disarticulation Including Attachment Plate Molded To Patient Model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,847.77 / $3,847.77 / $3,847.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,896.26 / $3,714.37 / $3,847.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,935.22 / $4,593.82 / $6,396.77
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,675.06 / $4,364.13 / $4,593.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,550.04 / $14,174.37 / $39,368.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,325.75 / $5,645.30 / $6,763.70
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,415.15 / $13,599.61 / $30,998.51
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,325.75 / $5,325.75 / $5,480.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,353.81 / $4,593.82 / $21,140.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.30 / $2,277.79 / $4,613.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,625.10 / $5,441.30 / $6,529.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.30 / $2,035.96 / $4,613.03