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Montana rates for HCPCS 41250

Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of tongue

Insurance Carrier
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
$243.97 / $243.97 / $243.97
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.88 / $234.37 / $441.49