go back

Montana rates for HCPCS L5647

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

Facilitymedian $1,148 · 10th–90th $724–$1,4130%20%40%10th90th$1,148Professionalmedian $631 · 10th–90th $407–$1,3490%10%20%10th90th$631$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
$407.38 / $575.44 / $1,047.13
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,230.27 / $1,230.27
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,148.15 / $2,238.72
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,148.15 / $2,238.72
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $1,071.52 / $1,348.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $912.01 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $724.44 / $758.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$426.58 / $478.63 / $741.31