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Montana rates for HCPCS 64635

Dstr Nrolytc Agnt Parverteb Fct Sngl Lmbr/Sacral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,616.16 / $4,227.46 / $8,464.85
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,473.00 / $4,370.82 / $4,666.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.71 / $425.91 / $2,880.00
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$293.02 / $678.34 / $2,799.00
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
$302.33 / $332.57 / $697.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.33 / $302.33 / $302.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.99 / $373.41 / $691.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.13 / $302.33 / $420.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.56 / $437.94 / $842.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.57 / $684.98 / $835.84