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Minnesota rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,079.40 / $1,079.40 / $1,079.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$650.09 / $1,079.40 / $1,079.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,103.93 / $1,288.69 / $1,794.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.95 / $1,224.26 / $1,288.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $3,975.78 / $11,042.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,494.00 / $1,583.64 / $1,897.38
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,360.37 / $3,814.56 / $8,694.79
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,494.00 / $1,494.00 / $1,537.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.50 / $1,288.69 / $6,807.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.61 / $642.91 / $1,413.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,460.51 / $1,718.25 / $2,061.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.61 / $642.91 / $1,375.81