go back

Montana rates for HCPCS 15002

Prep Site Trunk/Arm/Leg 1st 100 Sq Cm/1pct

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,559.34 / $2,559.34 / $2,559.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.81 / $287.94 / $582.29
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
$291.85 / $343.35 / $541.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$343.35 / $343.35 / $343.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.85 / $380.05 / $573.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$193.09 / $330.77 / $555.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.85 / $410.86 / $657.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.89 / $592.36 / $636.33