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Montana rates for HCPCS A4354

Insertion Tray With Drainage Bag But Without Catheter (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.51 / $9.90 / $47.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.69 / $13.69 / $13.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.73 / $14.73 / $14.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.42 / $14.73 / $14.73
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.52 / $13.35 / $14.73
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.04 / $11.04 / $16.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.32 / $6.99 / $8.01