go back

Montana rates for HCPCS L4370

Pneumatic Full Leg Splint Prefabricated Off-The-Shelf (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.80 / $140.51 / $613.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.81 / $227.81 / $227.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.11 / $244.94 / $244.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.11 / $199.20 / $244.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.58 / $233.28 / $244.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.11 / $183.84 / $248.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.90 / $106.10 / $121.46