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Montana rates for HCPCS 14301

Adjnt Tis Trnsfr/Reargmt Any Area 30.1-60 Sq Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,895.08 / $10,556.40 / $61,912.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.78 / $948.80 / $2,228.65
Aetna
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$61.79 / $624.02 / $640.75
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
$1,164.25 / $1,369.71 / $1,713.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,369.71 / $1,369.71 / $1,369.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,164.25 / $1,471.88 / $1,779.17
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.96 / $1,054.65 / $1,963.17
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,017.32 / $1,471.14 / $2,041.08
Providence
Facility/Professional
Professional
Modifier
AS
Low / Median / High Price
$276.12 / $276.12 / $302.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,624.98 / $1,820.75 / $1,955.91