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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

Facilitymedian $155 · 10th–90th $98–$1950%20%10th90th$155Professionalmedian $95 · 10th–90th $52–$1660%10%20%10th90th$95$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
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $91.20 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $154.88
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $165.96 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $165.96 / $165.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $154.88 / $302.00
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $154.88 / $302.00
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $147.91 / $190.55
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $79.43 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $70.79 / $107.15