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Montana rates for HCPCS L5250

Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot

Facilitymedian $7,586 · 10th–90th $4,786–$9,5500%20%10th90th$7,586Professionalmedian $5,012 · 10th–90th $2,692–$9,5500%10%10th90th$5,012$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
$2,691.53 / $4,677.35 / $6,918.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $8,128.31 / $8,128.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $8,128.31 / $8,128.31
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $7,585.78 / $14,791.08
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,025.60 / $7,585.78 / $14,791.08
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $7,244.36 / $9,332.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $6,165.95 / $8,128.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $4,677.35 / $4,897.79
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,090.30 / $4,786.30