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Montana rates for HCPCS 50840

Replacement of all or part of ureter by intestine segment, including intestine anastomosis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,584.89 / $3,090.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,905.46 / $2,041.74
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,137.96 / $2,344.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,137.96 / $2,344.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,778.28 / $2,344.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,258.93 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,089.30 / $3,019.95