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Montana rates for HCPCS L5665

Addition to lower extremity, socket insert, multidurometer, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.63 / $2,364.17 / $2,364.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.15 / $600.15 / $600.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.18 / $645.28 / $645.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.18 / $524.75 / $645.28
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.62 / $614.54 / $645.28
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$452.18 / $484.31 / $645.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.10 / $306.58 / $472.45