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Montana rates for HCPCS 64620

Dstrj Neurolytic Agent Intercostal Nerve

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,991.18 / $3,991.18 / $3,991.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.53 / $239.88 / $430.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.73 / $279.73 / $332.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.73 / $279.73 / $279.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.47 / $282.45 / $341.63
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.02 / $191.16 / $381.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.53 / $289.58 / $409.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.95 / $345.67 / $430.18