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Montana rates for HCPCS L5858

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

Facilitymedian $22,387 · 10th–90th $14,454–$27,5420%20%40%10th90th$22,387Professionalmedian $14,125 · 10th–90th $7,079–$27,5420%10%20%10th90th$14,125$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
$7,079.46 / $13,182.57 / $19,952.62
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $23,988.33 / $23,988.33
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14,454.40 / $23,988.33 / $23,988.33
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$17,378.01 / $22,387.21 / $43,651.58
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17,378.01 / $22,387.21 / $43,651.58
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,715.19 / $19,054.61 / $32,359.37
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $17,782.79 / $23,988.33
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,182.57 / $15,135.61 / $15,848.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,120.11 / $10,000.00 / $15,488.17