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Montana rates for HCPCS L5857

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

Facilitymedian $10,233 · 10th–90th $6,607–$12,5890%20%40%10th90th$10,233Professionalmedian $6,457 · 10th–90th $3,236–$12,5890%10%10th90th$6,457$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
$3,235.94 / $6,165.95 / $9,120.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $10,964.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $10,964.78
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $10,232.93 / $19,952.62
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,943.28 / $10,232.93 / $19,952.62
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,943.28 / $14,791.08
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $8,128.31 / $10,964.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $6,918.31 / $7,244.36
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,570.88 / $7,079.46