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Montana rates for HCPCS 15570

Formation of direct or tubed pedicle, with or without transfer; trunk

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,151.50 / $1,151.50 / $1,151.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.17 / $883.60 / $1,643.15