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Montana rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Facilitymedian $219 · 10th–90th $170$3020%20%40%10th90th$219Professionalmedian $178 · 10th–90th $95$2750%10%20%10th90th$178$100.0$200.0$500.0$1.0K

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
$95.50 / $162.18 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $234.42 / $234.42
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $426.58
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $426.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $229.09 / $316.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $177.83 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $169.82 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $112.20 / $173.78