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Montana rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Facilitymedian $4,677 · 10th–90th $3,548–$6,6070%20%40%10th90th$4,677Professionalmedian $3,548 · 10th–90th $2,089–$5,8880%10%10th90th$3,548$100.0$500.0$2.0K$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
$2,089.30 / $3,311.31 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,128.61 / $5,128.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,548.13 / $5,128.61 / $5,128.61
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,677.35 / $9,120.11
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $4,677.35 / $9,120.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $4,466.84 / $6,918.31
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,801.89 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,630.78 / $3,801.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,398.83 / $3,715.35