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Montana rates for HCPCS A5113

Leg strap; latex, replacement only, per set

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.98 / $7.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $5.89 / $5.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.39 / $4.79 / $5.89
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.27 / $5.50 / $10.72
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.27 / $5.50 / $10.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.02 / $5.25 / $6.76
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.37 / $5.89 / $79.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.24 / $2.51 / $3.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.51 / $2.82 / $3.24