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Montana rates for HCPCS L5677

Additions to lower extremity, below knee (BK), knee joints, polycentric, pair

Facilitymedian $575 · 10th–90th $407–$8510%20%40%10th90th$575Professionalmedian $417 · 10th–90th $257–$7080%10%10th90th$417$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
$257.04 / $389.05 / $691.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $616.60 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $616.60 / $616.60
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $575.44 / $1,122.02
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $575.44 / $1,122.02
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $588.84 / $912.01
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $467.74 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $446.68 / $467.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $295.12 / $457.09