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Montana rates for HCPCS 20933

Allograft, includes templating, cutting, placement and internal fixation, when performed; hemicortical intercalary, partial (ie, hemicylindrical) (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.46 / $954.93 / $3,408.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,081.57 / $1,081.57 / $1,081.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.77 / $883.62 / $1,081.57
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$534.02 / $581.40 / $1,081.57
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.20 / $993.41 / $1,432.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$960.85 / $1,092.73 / $1,213.44