go back

Minnesota rates for HCPCS L5782

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy-duty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $4,265.80 / $4,265.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,754.23 / $4,265.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,128.61 / $7,413.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $5,128.61 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,964.78 / $19,054.61 / $45,708.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,888.44 / $6,760.83 / $7,413.10
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $19,054.61 / $36,307.81
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,888.44 / $5,888.44 / $7,943.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $5,128.61 / $9,332.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,290.87 / $5,495.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $3,019.95 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,511.89 / $5,888.44