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Montana rates for HCPCS 65091

Evisceration Ocular Contents W/O Implant

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,168.84 / $1,168.84 / $1,168.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$659.43 / $957.60 / $1,168.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,490.00 / $1,490.00 / $1,490.00