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Minnesota rates for HCPCS L6697

Addition To Upper Extremity Prosthesis Below Elbow/Above Elbow Custom

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,330.08 / $1,330.08 / $1,330.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.08 / $1,249.51 / $1,330.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,360.31 / $1,587.98 / $2,211.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,270.38 / $1,508.58 / $1,587.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,111.22 / $4,899.63 / $13,608.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.88 / $1,951.33 / $2,337.91
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,908.85 / $4,700.95 / $10,715.20
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.88 / $1,840.88 / $1,894.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.71 / $1,587.98 / $7,396.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.92 / $791.65 / $1,594.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.92 / $773.22 / $1,594.62