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Montana rates for HCPCS 50705

Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $891.25 / $4,265.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $269.15 / $2,818.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $407.38 / $3,235.94
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $407.38 / $3,235.94
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $338.84 / $3,467.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $269.15 / $3,388.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $776.25 / $3,548.13