go back

Montana rates for HCPCS L1920

Ankle Foot Orthosis Single Upright With Static Or Adjustable Stop (Phelps Or Perlstein Type) Custom-Fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.83 / $1,185.01 / $1,185.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.11 / $520.14 / $520.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.11 / $422.98 / $520.14
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.58 / $495.37 / $520.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.11 / $390.38 / $520.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.59 / $196.49 / $224.93