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Montana rates for HCPCS 50715

Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,901.29 / $1,901.29 / $1,901.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$939.27 / $2,087.80 / $2,187.19