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Montana rates for HCPCS 27557

Open Tx Knee Dislocation W/Ligamentous Repair

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.54 / $1,457.23 / $5,459.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,652.59 / $1,652.59 / $1,652.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$884.59 / $1,652.59 / $1,763.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$816.91 / $1,123.25 / $1,652.59
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,003.82 / $1,652.59 / $2,172.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,423.62 / $1,726.52 / $2,604.92