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North Dakota rates for HCPCS L5814

Addition Endoskeletal Knee-Shin System Polycentric Hydraulic Swing Phase Control Mechanical Stance Phase Lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,297.68 / $3,297.68 / $3,297.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,297.68 / $3,755.33 / $3,755.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,237.99 / $5,010.80 / $5,135.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,197.50 / $5,249.48 / $6,600.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,973.38 / $3,508.69 / $20,912.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,805.73 / $2,997.20 / $3,665.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,332.09 / $2,997.20 / $4,753.55