go back

North Dakota rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$528.00 / $528.00 / $528.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$528.00 / $594.23 / $594.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$678.56 / $802.30 / $822.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.38 / $830.60 / $1,044.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.98 / $594.23 / $3,565.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.12 / $503.00 / $586.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.56 / $362.06 / $578.24