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Montana rates for HCPCS L3995

Addition to upper extremity orthosis, sock, fracture or equal, each

Facilitymedian $35 · 10th–90th $28–$1050%20%40%10th90th$35Professionalmedian $24 · 10th–90th $16–$410%20%10th90th$24$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$14.13 / $23.99 / $40.74
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $35.48 / $35.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $38.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $38.02 / $38.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$27.54 / $35.48 / $69.18
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $35.48 / $69.18
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.95 / $35.48 / $53.70
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $38.02 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17.78 / $20.42 / $22.39
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $17.78 / $27.54