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Montana rates for HCPCS A6412

Eye Patch Occlusive Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.15 / $0.19 / $1.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.53 / $0.53 / $0.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.53 / $0.53
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.63 / $0.63
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.49 / $0.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.22 / $0.22