go back

Montana rates for HCPCS 27057

Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) with debridement of nonviable muscle, unilateral

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.90 / $1,412.65 / $5,287.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,599.48 / $1,599.48 / $1,599.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$777.48 / $1,599.48 / $1,704.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$791.41 / $1,088.19 / $1,721.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$969.53 / $1,599.48 / $2,097.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,175.60 / $1,610.39 / $1,855.76