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Montana rates for HCPCS L5301

Below knee (BK), molded socket, shin, SACH foot, endoskeletal system

Facilitymedian $2,692 · 10th–90th $1,995–$3,8900%20%40%10th90th$2,692Professionalmedian $2,042 · 10th–90th $1,175–$3,3880%10%20%10th90th$2,042$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
$1,174.90 / $2,041.74 / $3,019.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $2,691.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,951.21 / $2,951.21
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,691.53 / $5,248.07
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,691.53 / $5,248.07
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $2,691.53 / $4,570.88
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $2,187.76 / $3,235.94
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,089.30 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,380.38 / $2,137.96