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Montana rates for HCPCS L0172

Cervical, collar, semi-rigid thermoplastic foam, two piece, prefabricated, off-the-shelf

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.90 / $85.90 / $85.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.10 / $145.10 / $145.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.38 / $156.01 / $156.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.38 / $126.87 / $156.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.73 / $148.58 / $156.01
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.38 / $117.09 / $162.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.48 / $71.36 / $81.68