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Hip Orthosis, Von Rosen Type, Custom Fabricated

Montana rates for HCPCS L1630

Hip orthosis (HO), abduction control of hip joints, semi-flexible (Von Rosen type), custom fabricated

Rates data updated October 2026.

How much does Hip Orthosis, Von Rosen Type, Custom Fabricated cost?

$200

Typical negotiated rate. In Montana, October 2026.

Insurers have agreed to pay about $200 for this service. The price depends on where it is billed: about $195 from a physician practice, and about $200 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$195$95.50 to $200
FacilityA hospital or hospital-owned outpatient department$200$195 to $11,220

How much rates vary

Facilitymedian $200 · 10th to 90th $129 to $11,482Professionalmedian $195 · 10th to 90th $79 to $214
$100$200$500$1K$2K$5K$10Kfacility $200professional $195

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$61.66
Median
$131.83
Typical High
$181.97
Cigna
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$199.53
Typical High
$199.53
Cigna
Setting
Professional
Modifier
None
Typical Low
$162.18
Median
$199.53
Typical High
$199.53
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$147.91
Median
$245.47
Typical High
$11,481.54
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$194.98
Median
$213.80
Typical High
$11,748.98
Providence
Setting
Facility
Modifier
None
Typical Low
$120.23
Median
$199.53
Typical High
$199.53
Providence
Setting
Professional
Modifier
None
Typical Low
$79.43
Median
$151.36
Typical High
$199.53
United
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$95.50
Typical High
$158.49

Where Montana sits

The same service costs 2.8 times more in Wisconsin than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 7th of 51

$200

WI $240DE $87.10

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.