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Montana rates for HCPCS C9359

Porous purified collagen matrix bone void filler (Integra Mozaik Osteoconductive Scaffold Putty, Integra OS Osteoconductive Scaffold Putty), per 0.5 cc

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,240.00 / $2,240.00 / $2,240.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.00 / $120.35 / $120.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $129.47 / $129.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.00 / $116.00 / $116.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.47 / $1,800,000.00 / $2,400,000.00