go back

Montana rates for HCPCS 19303

Mastectomy, simple, complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,320.09 / $18,320.09 / $28,924.01
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,255.21 / $5,607.23 / $26,300.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,518.51 / $1,518.51 / $1,518.51
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.12 / $1,672.45 / $1,788.71