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Montana rates for HCPCS L1630

Hip Orthosis Abduction Control Of Hip Joints Semi-Flexible (Von Rosen Type) Custom-Fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.83 / $599.20 / $599.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.29 / $200.45 / $200.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.29 / $200.45 / $200.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.43 / $190.90 / $200.45
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.44 / $153.78 / $219.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.08 / $95.24 / $109.02