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Minnesota rates for HCPCS L5722

Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,133.33 / $1,133.33 / $1,133.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.38 / $1,011.00 / $1,133.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,159.09 / $1,353.09 / $1,884.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.47 / $1,285.44 / $1,353.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.29 / $4,174.41 / $11,594.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.63 / $1,662.74 / $1,992.15
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,478.30 / $4,005.14 / $9,129.19
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.63 / $1,568.63 / $1,614.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.49 / $1,353.09 / $5,634.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.42 / $603.70 / $1,358.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.42 / $603.70 / $1,530.34