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Montana rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Facilitymedian $17 · 10th–90th $13$260%20%10th90th$17Professionalmedian $11 · 10th–90th $7$220%20%10th90th$11$5.0$10.0$20.0$50.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.96 / $15.85
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$18.62 / $18.62 / $18.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $18.62 / $18.62
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.80 / $17.38 / $33.88
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.80 / $17.38 / $33.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $16.98 / $21.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.13 / $18.62 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.76 / $7.59 / $9.33