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Montana rates for HCPCS L5652

Addition to lower extremity, suction suspension, above knee (AK) or knee disarticulation socket

Facilitymedian $676 · 10th–90th $427–$8510%20%10th90th$676Professionalmedian $347 · 10th–90th $170–$7590%20%10th90th$347$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
$169.82 / $338.84 / $537.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $724.44 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $724.44 / $724.44
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $676.08 / $1,318.26
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $676.08 / $1,318.26
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $537.03 / $831.76
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $524.81 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$346.74 / $389.05 / $416.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $263.03 / $398.11