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Montana rates for HCPCS 26123

Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft);

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,910.25 / $1,910.25 / $4,594.00
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
$1,342.89 / $1,342.89 / $1,342.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$666.74 / $860.97 / $1,342.89