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Montana rates for HCPCS L5856

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,529.40 / $81,610.60 / $81,610.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,591.13 / $28,591.13 / $28,591.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,200.25 / $30,741.19 / $30,741.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,200.25 / $30,741.19 / $30,741.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.49 / $29,277.32 / $30,741.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,200.25 / $23,072.63 / $30,763.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,690.25 / $12,934.33 / $20,513.75