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Montana rates for HCPCS 43400

Ligation Direct Esophageal Varices

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,309.79 / $1,487.32 / $7,841.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.80 / $2,400.80 / $2,400.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,434.81 / $2,400.59 / $4,124.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,468.83 / $2,039.70 / $2,817.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,503.68 / $2,451.19 / $4,084.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,127.87 / $2,585.12 / $4,205.04