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Montana rates for HCPCS L5505

Initial, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Facilitymedian $2,291 · 10th–90th $1,622–$3,0200%20%40%10th90th$2,291Professionalmedian $1,349 · 10th–90th $891–$2,8840%10%20%10th90th$1,349$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
$891.25 / $1,348.96 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,454.71 / $2,454.71
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,290.87 / $4,466.84
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,290.87 / $4,466.84
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,187.76 / $3,235.94
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,862.09 / $2,454.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,584.89 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,047.13 / $1,621.81