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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

Facilitymedian $28,840 · 10th–90th $18,197–$35,4810%20%40%10th90th$28,840Professionalmedian $18,197 · 10th–90th $9,120–$33,8840%10%20%10th90th$18,197$100.0$500.0$2.0K$10.0K$50.0K

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
$9,120.11 / $17,378.01 / $25,703.96
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28,840.32 / $28,840.32 / $28,840.32
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,218.10 / $30,902.95 / $30,902.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $30,902.95 / $30,902.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $28,840.32 / $56,234.13
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22,387.21 / $28,840.32 / $56,234.13
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $26,915.35 / $41,686.94
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $22,908.68 / $30,902.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16,982.44 / $19,498.45 / $20,417.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $12,882.50 / $19,952.62