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Montana rates for HCPCS 33694

Compl Rpr T-Fallot W/O Pulm Atresia Tanulr Patch

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,887.31 / $2,858.61 / $9,934.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,018.09 / $3,018.09 / $3,018.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,245.35 / $3,018.09 / $3,018.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,018.09 / $3,650.40 / $3,772.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,849.45 / $2,620.10 / $4,001.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,864.16 / $3,425.71 / $5,289.14