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Montana rates for HCPCS 42810

Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.58 / $385.61 / $1,460.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $77,999.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$384.36 / $384.36 / $528.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.19 / $452.19 / $452.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.98 / $452.19 / $885.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.79 / $385.25 / $723.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$376.23 / $621.50 / $999.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.00 / $638.01 / $770.01