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Montana rates for HCPCS L6400

Below Elbow Molded Socket Endoskeletal System Including Soft Prosthetic Tissue Shaping

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,088.99 / $10,714.00 / $10,714.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,125.02 / $3,899.05 / $3,899.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,125.02 / $3,170.75 / $3,899.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,552.72 / $3,713.38 / $3,899.05
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,125.02 / $2,926.41 / $3,901.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.78 / $1,389.43 / $2,141.06