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Montana rates for HCPCS L5617

Addition to lower extremity, quick change self-aligning unit, above knee (AK) or below knee (BK), each

Facilitymedian $661 · 10th–90th $437–$8320%20%10th90th$661Professionalmedian $427 · 10th–90th $214–$7760%10%10th90th$427$100.0$200.0$500.0$1.0K$2.0K

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
$213.80 / $398.11 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $707.95 / $707.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $660.69 / $1,288.25
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $660.69 / $1,288.25
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $630.96 / $977.24
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $537.03 / $707.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $457.09 / $478.63
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $302.00 / $467.74