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Montana rates for HCPCS 99477

Initial Hosp Neonate 28 D/< Not Critically Ill

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.95 / $336.83 / $893.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$474.64 / $527.38 / $527.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$527.38 / $527.38 / $527.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.88 / $477.70 / $752.14
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.74 / $449.54 / $640.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.55 / $579.16 / $901.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$454.02 / $565.79 / $690.89