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Montana rates for HCPCS 65290

Rpr Wnd Extraocular Muscle Tendon&/Tenon Capsu

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.35 / $2,597.27 / $2,597.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.04 / $765.04 / $765.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.46 / $495.06 / $807.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$462.62 / $765.04 / $980.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.37 / $650.79 / $906.73
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
$722.81 / $806.21 / $931.31