go back

Montana rates for HCPCS L2128

Knee-ankle-foot orthosis (KAFO), fracture orthosis, femoral fracture cast orthosis, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.26 / $6,994.72 / $6,994.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,886.53 / $1,886.53 / $1,886.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,207.09 / $2,028.39 / $2,028.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.09 / $1,649.51 / $2,028.39
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,077.02 / $1,931.80 / $2,028.39
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.09 / $1,522.40 / $2,221.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.06 / $963.76 / $1,103.23