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Montana rates for HCPCS 57426

Revision (including removal) of prosthetic vaginal graft, laparoscopic approach

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,384.43 / $1,384.43 / $1,384.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$679.04 / $1,541.15 / $1,566.07