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Montana rates for HCPCS L5986

All lower extremity prostheses, multiaxial rotation unit (MCP or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$843.58 / $2,925.94 / $2,925.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$990.33 / $990.33 / $990.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$663.31 / $1,064.82 / $1,064.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.31 / $865.91 / $1,064.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.04 / $1,014.11 / $1,064.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.31 / $799.18 / $1,065.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$342.95 / $379.44 / $632.40