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Montana rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Facilitymedian $4,467 · 10th–90th $2,951–$5,4950%20%40%10th90th$4,467Professionalmedian $3,311 · 10th–90th $1,778–$5,3700%10%20%10th90th$3,311$100.0$500.0$2.0K$10.0K

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
$1,778.28 / $3,235.94 / $4,570.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,466.84 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,786.30 / $4,786.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,786.30 / $4,786.30
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,466.84 / $8,709.64
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,466.84 / $8,709.64
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,265.80 / $5,888.44
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $3,548.13 / $5,011.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,090.30 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,041.74 / $3,162.28