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Montana rates for HCPCS L1830

Knee orthosis (KO), immobilizer, canvas longitudinal, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $58.88 / $269.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $87.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $93.33 / $93.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $89.13 / $93.33
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $75.86 / $117.49
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $75.86 / $117.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.15 / $74.13 / $120.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $79.43 / $93.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$48.98 / $52.48 / $61.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $48.98 / $61.66