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Montana rates for HCPCS 65140

Insertion of ocular implant secondary; after enucleation, muscles attached to implant

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,146.22 / $4,607.45 / $4,607.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,459.62 / $1,459.62 / $1,459.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.11 / $824.65 / $1,459.62
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$799.97 / $985.14 / $1,459.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$882.62 / $1,261.70 / $1,741.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,490.00 / $1,490.00 / $1,490.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,209.45 / $1,420.41 / $1,640.82