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Montana rates for HCPCS 61736

Laser interstitial thermal therapy (LITT) of lesion, intracranial, including burr hole(s), with magnetic resonance imaging guidance, when performed; single trajectory for 1 simple lesion

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,917.59 / $1,917.59 / $1,917.59
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$857.35 / $1,194.83 / $1,917.59