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Montana rates for HCPCS 0220T

Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,408.71 / $1,510.00 / $1,510.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,185.21 / $2,185.21 / $2,185.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,857.44 / $1,966.70 / $2,185.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$833.07 / $833.07 / $2,185.21
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,857.44 / $2,185.21 / $2,904.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,002.26 / $2,277.08 / $2,591.16