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Montana rates for HCPCS L5510

Preparatory, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, molded to model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,756.44 / $6,092.11 / $6,092.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,975.86 / $1,975.86 / $1,975.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,375.24 / $2,124.44 / $2,124.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,375.24 / $1,727.62 / $2,124.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.22 / $2,023.28 / $2,124.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,375.24 / $1,594.49 / $2,125.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$787.91 / $871.76 / $1,343.35