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Minnesota rates for HCPCS L5857

Addition To Lower Proximity Prosthesis Endoskeletal Knee-Shin System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,613.23 / $8,613.23 / $8,613.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,747.20 / $8,122.51 / $8,613.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,808.98 / $10,283.25 / $14,319.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,226.60 / $9,769.09 / $10,283.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,652.12 / $31,728.61 / $88,123.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,921.25 / $12,636.53 / $15,139.99
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,836.90 / $30,442.05 / $69,388.61
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,921.25 / $11,921.25 / $12,267.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,059.86 / $10,283.25 / $48,028.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,067.77 / $5,138.51 / $10,326.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,067.77 / $5,130.20 / $10,326.25