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Montana rates for HCPCS L5980

All lower extremity prostheses, flex-foot system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $3,715.35 / $4,365.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,754.40 / $5,754.40 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $6,165.95 / $6,165.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $5,011.87 / $6,165.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $5,754.40 / $11,220.18
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $5,754.40 / $11,220.18
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $5,128.61 / $6,760.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $4,677.35 / $6,165.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $3,311.31 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,238.72 / $3,388.44