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Montana rates for HCPCS A4257

Replacement Lens Shield Cartridge For Use With Laser Skin Piercing Device Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.88 / $10.70 / $51.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.72 / $18.72 / $18.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.28 / $18.72 / $18.72
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.38 / $16.97 / $18.72
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.05 / $14.05 / $20.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.83 / $7.56 / $8.89