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Montana rates for HCPCS L5639

Addition to lower extremity, below knee (BK), wood socket

Facilitymedian $1,738 · 10th–90th $1,096–$2,1880%20%10th90th$1,738Professionalmedian $977 · 10th–90th $575–$2,1880%10%20%10th90th$977$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
$575.44 / $912.01 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$870.96 / $1,905.46 / $1,905.46
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,737.80 / $3,388.44
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,737.80 / $3,388.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,584.89 / $1,905.46
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,412.54 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,000.00 / $1,071.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $676.08 / $1,023.29