go back

Montana rates for HCPCS L5920

Addition, endoskeletal system, above knee (AK) or hip disarticulation, alignable system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.76 / $1,837.43 / $1,837.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.51 / $823.51 / $823.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.94 / $885.43 / $885.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.94 / $720.06 / $885.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.05 / $843.27 / $885.43
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.94 / $664.56 / $886.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.14 / $317.70 / $503.89