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Montana rates for HCPCS L5500

Initial, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Facilitymedian $1,995 · 10th–90th $1,259–$2,4550%20%40%10th90th$1,995Professionalmedian $1,023 · 10th–90th $661–$2,2390%10%20%10th90th$1,023$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
$660.69 / $1,000.00 / $1,698.24
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $2,137.96 / $2,137.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,995.26 / $3,890.45
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,995.26 / $3,890.45
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,862.09 / $2,454.71
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,548.82 / $2,137.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,148.15 / $1,230.27
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $776.25 / $1,174.90