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Montana rates for HCPCS 67570

Optic nerve decompression (eg, incision or fenestration of optic nerve sheath)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,055.19 / $1,728.81 / $6,597.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.41 / $1,995.41 / $1,995.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,195.25 / $1,206.09 / $1,995.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,229.44 / $1,428.79 / $1,995.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,200.92 / $1,873.53 / $2,382.52
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
$1,745.82 / $2,033.76 / $2,390.57