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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
$524.81 / $831.76 / $1,202.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $1,047.13 / $1,288.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $1,202.26 / $2,344.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,202.26 / $2,344.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,122.02 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $954.99 / $1,318.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $645.65 / $676.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $524.81 / $588.84