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Montana rates for HCPCS L5656

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

Facilitymedian $447 · 10th–90th $339–$6030%20%40%10th90th$447Professionalmedian $363 · 10th–90th $191–$5620%10%20%10th90th$363$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
$190.55 / $363.08 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$338.84 / $478.63 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$338.84 / $478.63 / $478.63
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $446.68 / $870.96
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $446.68 / $870.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $467.74 / $645.65
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $363.08 / $562.34
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $331.13 / $354.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $223.87 / $338.84