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Montana rates for HCPCS L2200

Addition to lower extremity, limited ankle motion, each joint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.14 / $206.05 / $206.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.73 / $69.73 / $69.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.15 / $74.98 / $74.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $60.98 / $74.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.86 / $71.41 / $74.98
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $56.28 / $75.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.15 / $26.72 / $40.90