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Montana rates for HCPCS 67101

Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.45 / $616.16 / $752.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.35 / $445.35 / $525.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.81 / $525.79 / $1,288.55
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.41 / $442.14 / $732.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.45 / $582.17 / $1,240.96