go back

Montana rates for HCPCS L5535

Preparatory, below knee (BK) PTB type socket, nonalignable system, no cover, SACH foot, prefabricated, adjustable open end socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,257.51 / $7,830.09 / $7,830.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,271.83 / $2,137.15 / $2,137.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,271.83 / $1,737.95 / $2,137.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,134.77 / $2,035.38 / $2,137.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,271.83 / $1,604.03 / $2,340.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$917.76 / $1,015.43 / $1,564.74