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Montana rates for HCPCS L5940

Addition, endoskeletal system, below knee (BK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.29 / $1,846.21 / $1,846.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.92 / $783.92 / $783.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $842.88 / $842.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.03 / $685.43 / $842.88
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.66 / $802.74 / $842.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.03 / $632.61 / $843.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.47 / $300.36 / $476.36