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Montana rates for HCPCS L5050

Ankle, Symes, molded socket, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,658.44 / $9,220.69 / $9,220.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,918.11 / $2,918.11 / $2,918.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,084.13 / $3,137.55 / $3,137.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,084.13 / $2,551.48 / $3,137.55
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,535.70 / $2,988.14 / $3,137.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,084.13 / $2,354.87 / $3,139.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,070.48 / $2,070.48 / $2,175.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.02 / $1,374.19 / $2,117.59