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Montana rates for HCPCS L2800

Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.14 / $462.31 / $462.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.71 / $128.71 / $128.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.09 / $138.38 / $138.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.09 / $112.54 / $138.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.98 / $131.80 / $138.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.09 / $103.87 / $138.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.19 / $59.95 / $91.74