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Montana rates for HCPCS L5974

All Lower Extremity Prostheses Foot Single Axis Ankle/Foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.20 / $1,075.98 / $1,075.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.95 / $276.95 / $276.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.77 / $297.77 / $297.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.77 / $242.17 / $297.77
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.94 / $283.60 / $297.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.77 / $223.50 / $326.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.11 / $139.54 / $221.30