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Montana rates for HCPCS 27138

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,824.50 / $19,824.50 / $24,792.30
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
$2,401.85 / $2,401.85 / $2,401.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,188.90 / $1,634.73 / $2,401.85