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Montana rates for HCPCS G0412

Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring, includes internal fixation, when performed

Insurance Carrier
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,153.08 / $1,153.08 / $1,153.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$570.41 / $784.32 / $1,327.62