go back

Montana rates for HCPCS 31030

Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.09 / $2,742.14 / $3,470.66
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
$814.99 / $814.99 / $814.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$754.85 / $881.73 / $1,151.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.62 / $1,143.34 / $1,269.43
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.91 / $824.44 / $1,151.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$897.08 / $1,125.75 / $1,775.99