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Montana rates for HCPCS L3221

Orthopedic footwear, mens shoe, depth inlay, each

Facilitymedian $148 · 10th–90th $69–$1510%50%10th90th$148Professionalmedian $69 · 10th–90th $40–$1480%10%10th90th$69$50.0$100.0$200.0

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
$39.81 / $61.66 / $93.33
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $138.04 / $138.04
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $151.36 / $151.36
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $151.36 / $151.36
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $83.18 / $158.49
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $91.20 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $67.61 / $70.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $56.23 / $83.18