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Montana rates for HCPCS 53453

Periurethral transperineal adjustable balloon continence device; removal, each balloon

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$809.95 / $809.95 / $809.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$566.80 / $566.80 / $566.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.80 / $566.80 / $566.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.50 / $39.07 / $566.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.33 / $58.61 / $1,383.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$951.15 / $1,100.34 / $1,305.50