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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
$630.96 / $891.25 / $1,621.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $977.24 / $1,047.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $1,096.48 / $1,288.25
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,096.48 / $1,288.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $954.99 / $1,513.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $870.96 / $1,318.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,047.13 / $1,202.26