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Montana rates for HCPCS 51580

Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations;

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,454.71 / $4,677.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $2,951.21 / $2,951.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,951.21 / $3,162.28
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $3,630.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $3,630.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $2,754.23 / $3,630.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,949.84 / $3,890.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $3,235.94 / $4,677.35