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Montana rates for HCPCS L5636

Addition to lower extremity, Symes type, medial opening socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.40 / $882.35 / $882.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.20 / $398.20 / $398.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$197.02 / $428.15 / $428.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.02 / $348.18 / $428.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$170.50 / $407.76 / $428.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.02 / $321.35 / $428.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.90 / $152.57 / $241.98