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Montana rates for HCPCS 64484

Njx Aa&/Strd Tfrml Epi Lumbar/Sacral Ea Addl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$91.07 / $867.10 / $2,853.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.59 / $114.29 / $1,420.00
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$69.93 / $143.31 / $204.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.45 / $80.45 / $175.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.45 / $80.45 / $80.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.64 / $86.72 / $175.62
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.03 / $84.83 / $197.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.20 / $112.45 / $213.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.59 / $168.73 / $242.73