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Montana rates for HCPCS L5105

Below knee (BK), plastic socket, joints and thigh lacer, SACH foot

Facilitymedian $4,467 · 10th–90th $3,020–$5,6230%20%40%10th90th$4,467Professionalmedian $3,090 · 10th–90th $1,820–$5,6230%10%10th90th$3,090$100.0$500.0$2.0K$10.0K

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
$1,819.70 / $2,884.03 / $4,677.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,786.30 / $4,786.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $4,786.30 / $4,786.30
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,466.84 / $8,709.64
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $4,466.84 / $8,709.64
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $4,265.80 / $5,888.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,630.78 / $4,786.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,162.28 / $3,311.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,089.30 / $3,235.94