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Montana rates for HCPCS A2004

Misc W/Motor Score 12-32

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.48 / $12.95 / $12.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.26 / $584.16 / $584.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.26 / $584.16 / $584.16
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.48 / $15.60 / $584.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.26 / $584.16 / $1,800,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.00 / $13.00 / $13.00