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Montana rates for HCPCS L5321

Above Knee Molded Socket Open End Sach Foot Endoskeletal System Single Axis Knee

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,375.37 / $15,175.80 / $15,175.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,852.38 / $3,852.38 / $3,852.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,481.10 / $4,142.08 / $4,142.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,481.10 / $3,368.38 / $4,142.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,199.34 / $3,944.84 / $4,142.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,481.10 / $3,108.82 / $4,548.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,965.23 / $2,965.23 / $3,116.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.74 / $1,968.04 / $3,121.29