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Minnesota rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,519.35 / $1,519.35 / $1,519.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.11 / $1,347.13 / $1,519.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,553.88 / $1,813.93 / $2,525.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,451.14 / $1,723.23 / $1,813.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $5,596.92 / $15,544.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,103.00 / $2,229.17 / $2,670.81
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,322.82 / $5,369.97 / $12,240.13
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,103.00 / $2,103.00 / $2,164.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$492.55 / $1,813.93 / $7,733.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.82 / $827.15 / $1,821.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.82 / $827.15 / $1,821.51