go back

Montana rates for HCPCS A4652

Microcapillary tube sealant

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.12 / $2.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.12 / $2.12 / $2.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.12 / $0.12 / $0.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,800,000.00 / $2,250,000.00 / $2,400,000.00