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Montana rates for HCPCS A4313

Insertion Tray Without Drainage Bag With Indwelling Catheter Foley Type Three-Way For Continuous Irrigation (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.21 / $74.67 / $74.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.54 / $21.58 / $24.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.54 / $18.29 / $24.42
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.59 / $23.26 / $24.42
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.54 / $18.32 / $24.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.71 / $8.71 / $12.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.92 / $10.97 / $12.56