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Montana rates for HCPCS 61702

Simple Intracranial Arysm Vertebrobasilar Crcj

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,101.18 / $20,136.20 / $20,136.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,399.51 / $6,399.51 / $6,399.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,035.64 / $6,399.51 / $6,986.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,148.14 / $6,853.60 / $7,332.57
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,851.27 / $5,777.50 / $8,333.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,503.68 / $6,791.79 / $11,178.61