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Montana rates for HCPCS L5975

All lower extremity prostheses, combination single axis ankle and flexible keel foot

Facilitymedian $550 · 10th–90th $363–$6920%20%10th90th$550Professionalmedian $355 · 10th–90th $178–$6460%10%10th90th$355$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $331.13 / $489.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $588.84 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $588.84 / $588.84
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $549.54 / $1,071.52
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $549.54 / $1,071.52
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $524.81 / $794.33
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $446.68 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $371.54 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $251.19 / $380.19