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Montana rates for HCPCS L5200

Above knee (AK), molded socket, single axis constant friction knee, shin, SACH foot

Facilitymedian $3,890 · 10th–90th $2,754–$5,2480%20%40%10th90th$3,890Professionalmedian $2,951 · 10th–90th $1,549–$4,7860%10%10th90th$2,951$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
$1,548.82 / $2,884.03 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $4,168.69 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $4,168.69 / $4,168.69
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,890.45 / $7,585.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,890.45 / $7,585.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $3,890.45 / $6,309.57
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,090.30 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,951.21 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,995.26 / $3,019.95