| BCBS Minnesota | Hip Arthroplasty (Hip Replacement) and Hip Resurfacing | 2025-08-04 |
| BCBS Minnesota | Reduction Mammoplasty | 2025-08-04 |
| BCBS Minnesota | Meniscal Allografts and Other Meniscal Implants | 2025-08-04 |
| BCBS Minnesota | Artificial Intervertebral Discs | 2025-08-04 |
| BCBS Minnesota | Blepharoplasty and Brow Ptosis Repair | 2025-08-04 |
| BCBS Minnesota | Gynecomastia Surgery | 2025-08-04 |
| BCBS Minnesota | Bunionectomy | 2025-08-04 |
| BCBS Minnesota | Osteochondral Allografts and Autografts in the Treatment of Focal Articular Cartilage Lesions | 2025-08-04 |
| BCBS Minnesota | Penile Prosthesis Implantation | 2025-08-04 |
| BCBS Minnesota | Spinal Cord and Dorsal Root Ganglion Stimulation | 2025-08-04 |