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Montana rates for HCPCS L5966

Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,148.15 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,698.24 / $1,698.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,380.38 / $1,698.24
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,584.89 / $3,090.30
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,584.89 / $3,090.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $1,513.56 / $2,041.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,258.93 / $1,698.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,071.52 / $1,122.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $707.95 / $1,096.48