go back

Montana rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.17 / $1,627.29 / $1,627.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.02 / $516.02 / $516.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.77 / $554.82 / $554.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.77 / $451.19 / $554.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.83 / $528.40 / $554.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.77 / $416.42 / $555.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.73 / $211.03 / $334.69