go back

Montana rates for HCPCS L5312

Knee disarticulation (or through knee), molded socket, single axis knee, pylon, SACH foot, endoskeletal system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,934.14 / $13,645.40 / $13,645.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,274.78 / $4,274.78 / $4,274.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,001.57 / $4,596.24 / $4,596.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,001.57 / $4,596.24 / $4,596.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,001.57 / $4,377.37 / $4,596.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,001.57 / $3,449.68 / $5,024.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,826.14 / $1,975.10 / $3,132.49