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Minnesota rates for HCPCS L5964

Addition Endoskeletal System Above Knee Flexible Protective Outer Surface Covering System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,133.49 / $1,133.49 / $1,133.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.12 / $1,077.56 / $1,133.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,159.25 / $1,353.27 / $1,884.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.61 / $1,285.60 / $1,353.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.38 / $4,175.43 / $11,596.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,569.00 / $1,663.14 / $1,992.63
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,478.91 / $3,967.39 / $9,131.45
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,569.00 / $1,569.00 / $1,614.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.89 / $1,353.27 / $5,917.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.85 / $627.39 / $1,358.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.85 / $626.20 / $1,358.93