go back

Montana rates for HCPCS 15860

Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,203.86 / $3,203.86 / $8,090.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.15 / $166.15 / $166.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.13 / $164.02 / $228.64