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Montana rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Facilitymedian $708 · 10th–90th $479–$9120%20%40%10th90th$708Professionalmedian $525 · 10th–90th $288–$8320%10%10th90th$525$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
$288.40 / $457.09 / $741.31
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $758.58 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$416.87 / $758.58 / $758.58
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $707.95 / $1,380.38
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $707.95 / $1,380.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $676.08 / $954.99
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $575.44 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$446.68 / $501.19 / $537.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $338.84 / $512.86