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Montana rates for HCPCS 54690

Laparoscopy, surgical; orchiectomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$683.47 / $3,456.77 / $3,456.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,030.57 / $1,030.57 / $1,030.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$754.27 / $1,030.57 / $1,097.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$509.75 / $1,264.25 / $1,298.52
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.12 / $931.78 / $1,344.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984.89 / $1,136.41 / $1,788.95