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Montana rates for HCPCS 25695

Open treatment of lunate dislocation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$678.52 / $896.50 / $3,325.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,018.48 / $1,018.48 / $1,018.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,018.47 / $1,018.47 / $1,018.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$527.40 / $1,018.47 / $1,060.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$504.65 / $693.89 / $1,018.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.03 / $1,018.47 / $1,326.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.34 / $1,043.09 / $1,199.86