go back

Montana rates for HCPCS 15050

Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $602.56 / $1,479.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $724.44 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $741.31 / $933.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $954.99 / $1,096.48
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $954.99 / $1,096.48
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $588.84 / $977.24
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $741.31 / $1,071.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $831.76 / $1,071.52