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Montana rates for HCPCS 40761

Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,141.68 / $5,716.49 / $5,716.49
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
$1,699.91 / $1,699.91 / $1,699.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,161.77 / $1,699.91 / $1,841.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,054.36 / $1,159.81 / $2,439.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,031.64 / $1,642.40 / $2,086.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,657.31 / $1,856.14 / $1,993.93