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Montana rates for HCPCS 12037

Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $794.33 / $912.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $489.78 / $776.25