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Montana rates for HCPCS L5648

Addition to lower extremity, above knee (AK), air, fluid, gel or equal, cushion socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$657.33 / $2,279.96 / $2,279.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.44 / $1,106.29 / $1,106.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.44 / $899.65 / $1,106.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$440.56 / $1,053.60 / $1,106.29
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.44 / $830.32 / $1,107.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.31 / $394.23 / $625.24