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Montana rates for HCPCS L5653

Addition to lower extremity, knee disarticulation, expandable wall socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$650.46 / $2,256.09 / $2,256.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$909.56 / $909.56 / $909.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.76 / $977.96 / $977.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.76 / $795.28 / $977.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.45 / $931.39 / $977.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.76 / $734.00 / $978.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.97 / $348.49 / $580.82