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Montana rates for HCPCS L5698

Addition to lower extremity, above knee (AK) or knee disarticulation, Silesian bandage

Facilitymedian $123 · 10th–90th $95$1700%20%10th90th$123Professionalmedian $98 · 10th–90th $52$1510%10%20%10th90th$98$50.0$100.0$200.0$500.0

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
$52.48 / $91.20 / $134.90
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $131.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $131.83 / $131.83
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $239.88
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $239.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $120.23 / $204.17
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $100.00 / $141.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $93.33 / $100.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $63.10 / $95.50