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Montana rates for HCPCS 40819

Exc Frenum Labial/Buccal

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,371.24 / $5,371.24 / $5,371.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.18 / $298.12 / $450.91
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.01 / $316.01 / $426.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.01 / $316.01 / $316.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.81 / $407.40 / $533.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.12 / $499.20 / $558.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.69 / $316.01 / $533.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.67 / $483.60 / $746.47