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Montana rates for HCPCS 49605

Rpr Lg Omphalocele/Gastroschisis W/Wo Prosth

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,206.29 / $4,882.52 / $25,359.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,711.38 / $7,711.38 / $7,711.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,644.04 / $7,650.63 / $14,222.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.03 / $6,401.59 / $9,018.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,858.62 / $7,894.43 / $13,154.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,796.65 / $8,387.37 / $10,437.84