go back

Montana rates for HCPCS 53621

Dilat Urethral Strix Filiform & Follwr Male Sbsq

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.68 / $113.71 / $376.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.00 / $112.00 / $112.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.00 / $120.47 / $256.58
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.11 / $209.95 / $216.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.61 / $156.10 / $265.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.10 / $230.85 / $450.47