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Montana rates for HCPCS L1951

Ankle foot orthosis (AFO), spiral, (Institute of Rehabilitative Medicine-type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.16 / $2,849.53 / $2,849.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$999.01 / $999.01 / $999.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$710.11 / $1,074.14 / $1,074.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.11 / $1,074.14 / $1,074.14
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.97 / $1,022.99 / $1,074.14
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.57 / $824.05 / $1,074.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.59 / $450.97 / $516.23