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Montana rates for HCPCS 0163U

Oncology (colorectal) screening, biochemical enzyme-linked immunosorbent assay (ELISA) of 3 plasma or serum proteins (teratocarcinoma derived growth factor-1 [TDGF-1, Cripto-1], carcinoembryonic antigen [CEA], extracellular matrix protein [ECM]), with demographic data (age, gender, CRC-screening compliance) using a proprietary algorithm and reported as likelihood of CRC or advanced adenomas

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $363.08 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $562.34 / $562.34
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $489.78 / $1,174.90
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $489.78 / $1,174.90
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $354.81 / $489.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $389.05