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Montana rates for HCPCS 12054

Repair Intermediate F/E/E/N/L&/Muc 7.6-12.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.42 / $324.42 / $324.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.09 / $302.10 / $622.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $77,999.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.50 / $346.50 / $605.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.50 / $346.50 / $346.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.52 / $380.05 / $605.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$192.20 / $348.09 / $590.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.77 / $418.56 / $731.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$526.65 / $621.76 / $679.43