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Montana rates for HCPCS L5646

Addition to lower extremity, below knee (BK), air, fluid, gel or equal, cushion socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.04 / $1,897.40 / $1,897.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.83 / $831.83 / $831.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$410.92 / $894.38 / $894.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.92 / $727.32 / $894.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.64 / $851.79 / $894.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.92 / $671.27 / $895.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.52 / $328.08 / $505.56