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Montana rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Facilitymedian $234 · 10th–90th $148–$6920%20%10th90th$234Professionalmedian $145 · 10th–90th $83–$2750%10%20%10th90th$145$100.0$500.0$2.0K$10.0K$50.0K

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
$83.18 / $125.89 / $229.09
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $69,183.10 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $251.19 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $251.19 / $251.19
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $457.09
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $234.42 / $457.09
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $218.78 / $302.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $186.21 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $147.91 / $154.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $97.72 / $151.36