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Lower Extremity Orthosis Addition, Lightweight Composite

Montana rates for HCPCS L2755

Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only

Rates data updated July 2026.

Facilitymedian $155 · 10th–90th $98$1950%20%10th90th$155Professionalmedian $123 · 10th–90th $52$1950%20%10th90th$123$50.0$100.0$200.0$500.0

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
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$83.18
Typical High
$660.69
BCBS
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$165.96
Typical High
$165.96
Cigna
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$165.96
Typical High
$165.96
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$154.88
Typical High
$302.00
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$154.88
Typical High
$302.00
Providence
Setting
Facility
Modifier
Global
Typical Low
$74.13
Median
$147.91
Typical High
$190.55
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$125.89
Typical High
$165.96
United
Setting
Facility
Modifier
Global
Typical Low
$69.18
Median
$79.43
Typical High
$87.10
United
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$70.79
Typical High
$107.15