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Montana rates for HCPCS 0620T

Endovascular venous arterialization, tibial or peroneal vein, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access when performed, all catheterization(s) and intraprocedural roadmapping and imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $7,943.28 / $10,964.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,623.41 / $5,623.41 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $5,623.41 / $5,623.41
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,079.46 / $7,244.36 / $7,413.10
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,079.46 / $7,244.36 / $7,413.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $7,413.10 / $7,943.28
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $5,623.41 / $19,952.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,481.54 / $16,595.87 / $19,952.62