go back

Montana rates for HCPCS Q4170

Cygnus, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.71 / $42.85 / $45.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $79,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.68 / $507.68 / $507.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.31 / $507.68 / $507.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.31 / $71.13 / $507.68
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.65 / $42.65 / $507.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.31 / $39.31 / $39.31