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Montana rates for HCPCS 29055

Application Cast Shoulder Spica

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.91 / $307.56 / $1,159.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.73 / $218.73 / $218.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.40 / $218.73 / $371.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.25 / $188.76 / $276.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.73 / $276.89 / $427.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.33 / $354.54 / $410.52