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Montana rates for HCPCS L3250

Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each

Facilitymedian $372 · 10th–90th $178–$3890%50%10th90th$372Professionalmedian $155 · 10th–90th $102–$3720%10%10th90th$155$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
$102.33 / $134.90 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $346.74 / $346.74
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $380.19 / $389.05
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$371.54 / $380.19 / $389.05
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $208.93 / $407.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $229.09 / $416.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $177.83 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $141.25 / $213.80