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Montana rates for HCPCS 51820

Cystourethroplasty with unilateral or bilateral ureteroneocystostomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,365.74 / $5,706.18 / $5,706.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.86 / $1,698.86 / $1,698.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,266.75 / $1,698.86 / $2,040.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.44 / $1,972.75 / $2,034.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.50 / $1,538.40 / $2,219.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,471.09 / $1,877.99 / $2,955.38