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Montana rates for HCPCS 28200

Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,318.30 / $4,905.20 / $9,199.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.66 / $441.93 / $4,346.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.07 / $573.16 / $780.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$521.07 / $521.07 / $521.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.10 / $521.07 / $822.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.45 / $413.57 / $636.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.11 / $607.95 / $979.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.28 / $797.44 / $911.37