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Montana rates for HCPCS L1755

Legg Perthes orthosis, (Patten bottom type), custom fabricated

Facilitymedian $1,738 · 10th–90th $1,318–$2,1880%20%10th90th$1,738Professionalmedian $1,122 · 10th–90th $813–$2,1880%10%10th90th$1,122$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,071.52 / $1,548.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,862.09 / $1,862.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,862.09 / $1,862.09
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,737.80 / $3,388.44
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,737.80 / $3,388.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,659.59 / $2,398.83
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,412.54 / $1,862.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,122.02 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $891.25 / $1,348.96