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Minnesota rates for HCPCS V5264

Ear mold/insert, not disposable, any type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.45 / $57.45 / $57.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.15 / $57.45 / $75.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.60 / $57.60 / $57.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.58 / $48.00 / $48.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.92 / $151.30 / $190.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.74 / $67.23 / $77.63
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.92 / $149.80 / $314.27
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.40 / $61.13 / $61.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.82 / $57.45 / $68.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.84 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.00 / $50.40 / $103.44