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Minnesota rates for HCPCS L5703

Ankle Symes Molded To Patient Model Socket Without Solid Ankle Cushion Heel (Sach) Foot Replacement Only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,551.00 / $2,551.00 / $2,551.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,241.53 / $2,210.96 / $2,551.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,608.96 / $3,045.61 / $4,240.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,436.48 / $2,893.33 / $3,045.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,119.51 / $9,396.82 / $26,098.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,530.63 / $3,742.46 / $4,483.89
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,578.78 / $9,015.79 / $20,550.29
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,530.63 / $3,530.63 / $3,633.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.91 / $3,045.61 / $13,256.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.06 / $1,398.72 / $3,058.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$980.76 / $1,640.47 / $5,217.99