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Montana rates for HCPCS L5700

Replacement Socket Below Knee Molded To Patient Model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,645.64 / $12,644.80 / $12,644.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,326.01 / $3,326.01 / $3,326.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.00 / $3,576.12 / $3,576.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,400.00 / $2,908.14 / $3,576.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,832.53 / $3,405.83 / $3,576.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,400.00 / $2,684.04 / $3,837.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,482.08 / $1,639.81 / $2,600.71