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Montana rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Facilitymedian $977 · 10th–90th $617–$1,2020%20%10th90th$977Professionalmedian $617 · 10th–90th $240–$1,2020%10%10th90th$617$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
$239.88 / $602.56 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $1,047.13 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $1,047.13 / $1,047.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$724.44 / $977.24 / $1,905.46
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $977.24 / $1,905.46
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $794.33 / $1,096.48
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $776.25 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $562.34 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $371.54 / $575.44