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Montana rates for HCPCS 23474

Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid component

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,320.82 / $16,320.82 / $33,580.78
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
$2,740.47 / $2,740.47 / $2,740.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,354.75 / $1,465.56 / $2,740.47