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Montana rates for HCPCS L3630

Transfer of an orthosis from one shoe to another, solid stirrup, new

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.56 / $340.89 / $340.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.56 / $128.51 / $128.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.56 / $128.51 / $128.51
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.29 / $122.39 / $128.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.56 / $96.45 / $128.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.76 / $53.95 / $61.76