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Montana rates for HCPCS 22865

Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,476.21 / $3,022.70 / $11,317.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,620.13 / $3,620.13 / $3,620.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,727.05 / $3,462.32 / $3,620.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,783.01 / $2,451.64 / $3,729.22
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,025.14 / $3,462.32 / $4,698.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,063.45 / $3,584.89 / $4,131.10