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Montana rates for HCPCS 99475

Initial inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 2 through 5 years of age

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$869.15 / $869.15 / $869.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.10 / $643.17 / $1,012.63