go back

Montana rates for HCPCS 01940

Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$137.15 / $137.15 / $137.15
Providence
Facility/Professional
Professional
Modifier
QX
Low / Median / High Price
$162.50 / $181.00 / $206.30
Providence
Facility/Professional
Professional
Modifier
QY
Low / Median / High Price
$162.50 / $181.00 / $206.30