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Montana rates for HCPCS L1610

Hip Orthosis Abduction Control Of Hip Joints Flexible (Frejka Cover Only) Prefabricated Item That Has Been Trimmed Bent Molded Assembled Orotherwise Customized To Fit A Specific Patient By An Individual With Expertise (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.98 / $190.26 / $190.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.91 / $51.93 / $51.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.91 / $42.23 / $51.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.58 / $49.46 / $51.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.91 / $38.97 / $51.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.30 / $24.67 / $37.76