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Montana rates for HCPCS 58301

Removal Intrauterine Device Iud

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$353.70 / $818.54 / $3,261.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.53 / $108.63 / $443.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.11 / $104.11 / $175.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.11 / $104.11 / $104.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.11 / $112.33 / $175.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.90 / $167.05 / $178.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.70 / $116.37 / $179.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.77 / $168.78 / $307.11