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Montana rates for HCPCS 58760

Fimbrioplasty

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $954.99 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,288.25 / $1,348.96
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,412.54 / $1,584.89
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,412.54 / $1,584.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $1,148.15 / $1,445.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $851.14 / $1,698.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,380.38 / $2,041.74