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Montana rates for HCPCS L2010

Knee-ankle-foot orthosis (KAFO), single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'AK' orthosis), without knee joint, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.27 / $4,007.29 / $4,007.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$740.83 / $1,279.74 / $1,279.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.83 / $1,040.69 / $1,279.74
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$580.75 / $1,218.80 / $1,279.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.83 / $960.50 / $1,309.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.69 / $519.67 / $594.89