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Montana rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

Facilitymedian $1,230 · 10th–90th $832–$1,5490%20%10th90th$1,230Professionalmedian $871 · 10th–90th $437–$1,5490%10%10th90th$871$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $831.76 / $1,202.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $1,348.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,348.96 / $1,348.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,230.27 / $2,398.83
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,230.27 / $2,398.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $1,174.90 / $1,621.81
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,000.00 / $1,348.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $851.14 / $891.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $562.34 / $870.96