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Montana rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Facilitymedian $5,888 · 10th–90th $3,715–$7,4130%20%10th90th$5,888Professionalmedian $3,802 · 10th–90th $1,950–$7,4130%10%20%10th90th$3,802$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
$1,949.84 / $3,630.78 / $5,011.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $6,456.54 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $6,456.54 / $6,456.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $5,888.44 / $11,481.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $5,888.44 / $11,481.54
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,495.41 / $7,079.46
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $4,786.30 / $6,456.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,467.37 / $3,630.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,290.87 / $3,548.13