go back

Montana rates for HCPCS 40701

Plstc Rpr Cl Lip/Nsl Dfrm Prim Bi 1 Stg Px

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,051.81 / $1,258.47 / $6,296.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,877.63 / $1,877.63 / $1,877.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,271.15 / $1,877.63 / $2,024.73
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,163.21 / $1,279.53 / $2,393.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,137.75 / $1,706.80 / $2,303.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,627.13 / $2,007.96 / $2,194.21