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Montana rates for HCPCS 0170U

Neurology (autism spectrum disorder [ASD]), RNA, next-generation sequencing, saliva, algorithmic analysis, and results reported as predictive probability of ASD diagnosis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,659.59 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,511.89 / $5,370.32
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,511.89 / $5,370.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $2,818.38 / $4,265.80
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,584.89 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $741.31 / $1,737.80