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Montana rates for HCPCS L5280

Hemipelvectomy Canadian Type; Molded Socket Hip Joint Single Axis Constant Friction Knee Shin Sach Foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,778.20 / $23,509.80 / $23,509.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,728.96 / $8,510.61 / $8,510.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,728.96 / $6,920.91 / $8,510.61
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,407.15 / $8,105.34 / $8,510.61
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,728.96 / $6,387.59 / $8,516.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,755.58 / $3,048.83 / $4,698.14