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Minnesota rates for HCPCS L5781

Addition To Lower Limb Prosthesis Vacuum Pump Residual Limb Volume Management And Moisture Evacuation System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,045.84 / $4,045.84 / $4,045.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,229.87 / $3,799.83 / $4,045.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,137.79 / $4,830.29 / $6,726.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,864.23 / $4,588.78 / $4,830.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,886.72 / $14,903.73 / $41,393.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,599.88 / $5,935.87 / $7,111.84
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,848.17 / $14,299.40 / $32,593.58
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,599.88 / $5,599.88 / $5,762.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,431.44 / $4,830.29 / $22,493.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.14 / $2,408.42 / $4,858.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,890.35 / $5,753.36 / $6,904.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.14 / $2,408.42 / $6,520.89