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Montana rates for HCPCS 52318

Litholapaxy Comp/Lg > 2.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,158.30 / $8,158.30 / $8,158.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.40 / $507.70 / $717.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.97 / $732.97 / $732.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$732.97 / $732.97 / $732.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.44 / $732.97 / $793.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.16 / $893.75 / $909.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.52 / $665.35 / $959.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$701.25 / $819.59 / $1,276.49