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Montana rates for HCPCS 49452

Replacement Gastro-Jejunostomy Tube Percutaneous

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,009.41 / $2,009.41 / $2,009.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.75 / $713.34 / $2,329.78
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
$208.74 / $208.74 / $1,195.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.74 / $208.74 / $208.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $658.48 / $1,678.71
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$129.18 / $717.28 / $1,683.08
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.87 / $779.64 / $2,067.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$885.82 / $885.82 / $885.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,169.83 / $1,462.05 / $1,796.54