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Montana rates for HCPCS 20930

Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$347.13 / $347.13 / $18,880.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.17 / $111.90 / $471.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.03 / $184.03 / $184.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.93 / $184.03 / $204.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.63 / $179.88 / $223.27
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.93 / $184.03 / $242.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.97 / $196.01 / $218.89