go back

Montana rates for HCPCS L2628

Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

Facilitymedian $2,455 · 10th–90th $1,549–$3,0900%20%10th90th$2,455Professionalmedian $1,514 · 10th–90th $646–$3,0200%10%20%10th90th$1,514$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,412.54 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,630.27 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,630.27 / $2,630.27
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,454.71 / $4,786.30
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,454.71 / $4,786.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,995.26 / $2,884.03
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,995.26 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,071.52 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $933.25 / $1,445.44