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Montana rates for HCPCS 14001

Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.89 / $2,972.00 / $8,773.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.95 / $739.64 / $1,651.72
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
$1,033.72 / $1,033.72 / $1,287.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,033.72 / $1,033.72 / $1,033.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.95 / $1,090.08 / $1,319.39
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$577.91 / $793.58 / $1,457.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$764.74 / $1,094.08 / $1,527.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,197.71 / $1,342.26 / $1,448.23