go back

Montana rates for HCPCS L5614

Addition to lower extremity, exoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with pneumatic swing phase control

Facilitymedian $1,995 · 10th–90th $1,318–$2,5120%20%40%10th90th$1,995Professionalmedian $1,288 · 10th–90th $646–$2,5120%10%10th90th$1,288$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$645.65 / $1,202.26 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,137.96 / $2,137.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,995.26 / $3,890.45
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,995.26 / $3,890.45
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,905.46 / $2,951.21
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,621.81 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,380.38 / $1,445.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $912.01 / $1,412.54