go back

Montana rates for HCPCS L5331

Hip disarticulation, Canadian type, molded socket, endoskeletal system, hip joint, single axis knee, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $4,786.30 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $7,079.46 / $7,079.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $5,754.40 / $7,079.46
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $6,606.93 / $12,882.50
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $6,606.93 / $12,882.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $6,309.57 / $8,709.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $5,248.07 / $7,079.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $4,168.69 / $4,365.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,754.23 / $4,265.80