go back

Montana rates for HCPCS L5859

Addition To Lower Extremity Prosthesis Endoskeletal Knee-Shin System Powered And Programmable Flexion/Extension Assist Control Includes Any Type Motor(S)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,221.34 / $49,326.00 / $49,326.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,292.83 / $17,292.83 / $17,292.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $18,593.25 / $18,593.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,812.54 / $18,593.25 / $18,593.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $17,707.86 / $18,593.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,812.54 / $13,955.06 / $18,606.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,301.45 / $7,834.36 / $12,425.25