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Montana rates for HCPCS L5961

Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,801.89 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $6,456.54 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $5,248.07 / $6,456.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $6,025.60 / $11,748.98
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $6,025.60 / $11,748.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $6,309.57 / $8,128.31
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $4,897.79 / $6,456.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $3,890.45 / $4,073.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,570.40 / $3,981.07