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Montana rates for HCPCS 27137

Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.98 / $2,312.98 / $2,312.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,144.76 / $1,574.05 / $2,312.98