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Montana rates for HCPCS V2784

Lens, Polycarbonate Or Equal, Any Index, Per Lens

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.00 / $45.40 / $55.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.43 / $24.43 / $24.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.72 / $41.23 / $57.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.43 / $48.69 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.96 / $25.40 / $36.44