go back

Montana rates for HCPCS L1000

Cervical-thoracic-lumbar-sacral orthosis (CTLSO) (Milwaukee), inclusive of furnishing initial orthotic, including model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,659.59 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $2,290.87 / $2,818.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,630.27 / $5,128.61
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,630.27 / $5,128.61
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $2,454.71 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $2,089.30 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,412.54 / $1,479.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,148.15 / $1,318.26