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Montana rates for HCPCS 58740

Lysis of adhesions (salpingolysis, ovariolysis)

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,430.18 / $1,430.18 / $1,430.18
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$704.86 / $1,541.80 / $1,624.89