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Montana rates for HCPCS 67560

Orbital Implant Removal/Revision

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,739.87 / $1,739.87 / $1,739.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$989.67 / $1,214.44 / $1,739.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,490.00 / $1,490.00 / $1,490.00