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Montana rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Facilitymedian $1,622 · 10th–90th $1,148–$1,9950%20%40%10th90th$1,622Professionalmedian $1,096 · 10th–90th $550–$1,9950%10%10th90th$1,096$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$549.54 / $1,023.29 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,737.80 / $1,737.80
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,621.81 / $3,162.28
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,621.81 / $3,162.28
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $1,513.56 / $2,137.96
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,288.25 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,122.02 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $741.31 / $1,148.15