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Montana rates for HCPCS 23174

Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to surgical neck

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,047.13 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,047.13 / $1,258.93
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,318.26 / $1,584.89
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,318.26 / $1,584.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,071.52 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,047.13 / $1,584.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,258.93 / $1,445.44