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Minnesota rates for HCPCS L8658

Interphalangeal Joint Spacer Silicone Or Equal Each. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.83 / $306.83 / $306.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.88 / $306.83 / $355.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $390.99 / $515.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.06 / $355.33 / $366.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.90 / $1,130.76 / $3,140.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.50 / $449.97 / $539.12
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$671.32 / $1,084.91 / $2,472.91
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$424.50 / $424.50 / $437.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.52 / $366.32 / $1,907.92
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.84 / $194.59 / $395.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.47 / $243.67 / $643.44