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Montana rates for HCPCS 49426

Revision of peritoneal-venous shunt

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$532.94 / $654.54 / $3,455.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,063.69 / $1,063.69 / $1,063.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.54 / $1,027.81 / $1,732.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.37 / $888.71 / $1,163.17
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.46 / $1,082.71 / $1,804.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$914.14 / $1,083.52 / $1,361.50