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Montana rates for HCPCS A5102

Expired, Orthopedic,Los>/=14

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.80 / $24.80 / $24.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.56 / $30.56 / $30.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.95 / $32.85 / $32.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.52 / $32.85 / $32.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.35 / $31.29 / $32.85
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.29 / $24.67 / $32.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.09 / $13.37 / $15.73