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Montana rates for HCPCS L6310

Shoulder Disarticulation Passive Restoration (Complete Prosthesis)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,039.77 / $14,011.70 / $14,011.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,141.52 / $3,824.37 / $3,824.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,141.52 / $3,235.77 / $3,824.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,030.64 / $3,642.26 / $3,824.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,870.36 / $3,141.52 / $4,188.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,642.31 / $1,817.08 / $2,800.07