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Montana rates for HCPCS L5220

Above knee (AK), short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each

Facilitymedian $3,548 · 10th–90th $2,455–$4,6770%20%40%10th90th$3,548Professionalmedian $2,692 · 10th–90th $1,445–$4,3650%10%20%10th90th$2,692$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$1,445.44 / $2,630.27 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,801.89 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,801.89 / $3,801.89
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,548.13 / $6,918.31
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $3,548.13 / $6,918.31
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,548.13 / $4,897.79
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,818.38 / $4,168.69
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,511.89 / $2,630.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,659.59 / $2,570.40