go back

Montana rates for HCPCS L5930

Addition, endoskeletal system, high activity knee control frame

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,299.12 / $11,442.80 / $11,442.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,999.13 / $3,999.13 / $3,999.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,282.71 / $4,299.87 / $4,299.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,282.71 / $4,299.87 / $4,299.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,036.74 / $4,095.11 / $4,299.87
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,194.75 / $3,298.77 / $4,302.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,647.23 / $1,822.54 / $2,890.53