go back

Montana rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $309 · 10th–90th $224–$4370%20%10th90th$309Professionalmedian $257 · 10th–90th $138–$3890%10%20%10th90th$257$100.0$200.0$500.0$1.0K

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
$138.04 / $251.19 / $354.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $331.13 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $331.13 / $331.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $309.03 / $602.56
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $309.03 / $602.56
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $323.59 / $478.63
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $251.19 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $239.88 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $158.49 / $245.47