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Montana rates for HCPCS 43763

Perq Replacement Gtube Req Revj Gstrst Trc

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.03 / $294.77 / $438.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.22 / $137.22 / $137.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.22 / $137.22 / $137.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.15 / $319.52 / $732.79
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.87 / $176.11 / $469.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.65 / $342.26 / $861.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$453.07 / $568.75 / $777.71