go back

Montana rates for HCPCS L5964

Addition Endoskeletal System Above Knee Flexible Protective Outer Surface Covering System

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,126.45 / $3,907.05 / $3,907.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,240.33 / $1,240.33 / $1,240.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.38 / $1,333.62 / $1,333.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$702.38 / $1,084.51 / $1,333.62
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$626.69 / $1,270.10 / $1,333.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$702.38 / $1,000.94 / $1,334.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.84 / $560.78 / $889.39