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Montana rates for HCPCS L2030

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.61 / $4,390.52 / $4,390.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$713.15 / $1,198.33 / $1,198.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.15 / $974.51 / $1,198.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$636.29 / $1,141.28 / $1,198.33
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.15 / $899.42 / $1,312.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.61 / $569.38 / $871.30