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Montana rates for HCPCS 0254U

Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using embryonic DNA genomic sequence analysis for aneuploidy, and a mitochondrial DNA score in euploid embryos, results reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplication, mosaicism, and segmental aneuploidy, per embryo tested

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $707.95 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,412.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $977.24 / $2,290.87
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $977.24 / $2,290.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,096.48 / $1,659.59
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $954.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $316.23 / $758.58