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North Dakota 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
$3,552.79 / $3,552.79 / $3,552.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,552.79 / $4,045.84 / $4,045.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,565.84 / $5,398.44 / $5,532.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,599.88 / $5,655.87 / $7,111.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,126.06 / $3,780.10 / $22,493.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,945.42 / $3,229.07 / $3,949.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,904.03 / $6,904.03 / $6,904.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.14 / $3,229.07 / $3,890.84