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Montana rates for HCPCS 25263

Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each tendon or muscle

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.87 / $896.90 / $3,315.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,020.05 / $1,020.05 / $1,020.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.05 / $1,020.05 / $1,020.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.54 / $1,020.05 / $1,049.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.74 / $695.40 / $1,020.05
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$612.71 / $1,020.05 / $1,325.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$854.93 / $1,037.04 / $1,164.16