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Montana rates for HCPCS 35642

Bypass graft, with other than vein; carotid-vertebral

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,106.06 / $4,983.54 / $4,983.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,525.87 / $1,525.87 / $1,525.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,239.19 / $1,525.87 / $1,525.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,525.87 / $1,961.05 / $2,137.85
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$937.18 / $1,327.70 / $2,027.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,487.72 / $1,716.60 / $2,670.46