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Montana rates for HCPCS 49605

Repair of large omphalocele or gastroschisis; with or without prosthesis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $5,370.32 / $14,125.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,762.47 / $7,762.47 / $7,762.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $6,606.93 / $14,454.40
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $8,317.64 / $9,332.54
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,317.64 / $8,317.64 / $9,332.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $6,606.93 / $12,022.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $7,762.47 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,456.54 / $8,128.31 / $10,232.93