go back

Montana rates for HCPCS 33500

Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $2,089.30 / $5,248.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $2,398.83
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,691.53 / $2,951.21
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,691.53 / $2,951.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,630.27 / $2,884.03
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,479.11 / $2,951.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,691.53 / $4,265.80