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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
$1,460.40 / $5,065.30 / $5,065.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.00 / $1,695.92 / $1,695.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$895.00 / $1,379.13 / $1,695.92
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$798.55 / $1,615.16 / $1,695.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$895.00 / $1,272.85 / $1,697.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.84 / $714.57 / $1,133.30