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North Dakota rates for HCPCS L5971

All lower extremity prostheses, solid ankle cushion heel (SACH) foot, replacement only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.28 / $198.28 / $198.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.28 / $219.64 / $219.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.80 / $301.27 / $308.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.13 / $307.17 / $386.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.87 / $198.28 / $1,295.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.57 / $182.41 / $220.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $182.41 / $217.14