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North Dakota 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
$877.09 / $877.09 / $877.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$877.09 / $1,133.33 / $1,133.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,127.17 / $1,332.71 / $1,365.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.63 / $1,584.31 / $1,992.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.19 / $1,044.20 / $5,634.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.36 / $810.95 / $974.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.42 / $601.42 / $960.54