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Montana rates for HCPCS 54322

1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.41 / $808.87 / $4,117.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,226.17 / $1,226.17 / $1,226.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.46 / $1,226.17 / $1,303.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.63 / $1,470.30 / $1,504.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.52 / $1,109.40 / $1,600.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,170.24 / $1,399.96 / $2,132.12