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Montana rates for HCPCS L2090

Hip-knee-ankle-foot orthosis (HKAFO), torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.54 / $1,900.41 / $1,900.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$387.54 / $576.63 / $576.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.54 / $468.93 / $576.63
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $549.16 / $576.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.54 / $432.78 / $601.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.74 / $246.45 / $282.11