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Montana rates for HCPCS 74713

Fetal Mri W/Placntl Matrnl Plvc Img Ea Addl Ges

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.47 / $375.00 / $1,323.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.16 / $321.79 / $408.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.06 / $304.18 / $547.89
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.17 / $321.79 / $408.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.83 / $338.08 / $521.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.17 / $204.35 / $409.44