go back

Montana rates for HCPCS L4010

Replace Trilateral Socket Brim

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.23 / $2,908.59 / $2,908.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$626.01 / $860.56 / $860.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.01 / $699.82 / $860.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.53 / $819.58 / $860.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$626.01 / $645.89 / $861.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.92 / $377.20 / $577.22