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Montana rates for HCPCS L5160

Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $3,890.45 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $5,370.32 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $4,365.16 / $5,370.32
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $5,011.87 / $9,772.37
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $5,011.87 / $9,772.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $4,786.30 / $6,606.93
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $4,073.80 / $5,623.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,467.37 / $3,630.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,290.87 / $3,548.13