go back

Montana rates for HCPCS L5520

Preparatory Below Knee Ptb Type Socket Non-Alignable System Pylon No Cover Sach Foot Thermoplastic Or Equal Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,913.21 / $6,635.89 / $6,635.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.72 / $1,812.31 / $1,812.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,232.72 / $1,473.79 / $1,812.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$962.29 / $1,726.01 / $1,812.31
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,232.72 / $1,360.22 / $1,813.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$778.27 / $861.09 / $1,365.68