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Minnesota rates for HCPCS L5968

Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,674.44 / $3,674.44 / $3,674.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,025.20 / $3,451.05 / $3,674.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,757.95 / $4,386.88 / $6,108.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,509.50 / $4,167.54 / $4,386.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,448.80 / $13,535.02 / $37,592.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,085.75 / $5,390.90 / $6,458.90
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,035.58 / $12,986.19 / $29,600.29
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,085.75 / $5,085.75 / $5,233.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.06 / $4,386.88 / $20,504.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,303.42 / $2,187.36 / $4,405.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,303.42 / $2,097.19 / $4,405.22