go back

Montana rates for HCPCS 76514

Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral (determination of corneal thickness)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $13.18 / $31.62
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$6.03 / $8.71 / $26.30
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$11.48 / $11.48 / $12.30
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3.02 / $4.47 / $8.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.14 / $66,069.34 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $17.78 / $17.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.17 / $8.32 / $23.44
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$12.02 / $12.02 / $14.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $17.78 / $27.54
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.12 / $12.02 / $18.62
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$2.82 / $5.75 / $10.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $19.95 / $25.70
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $19.95 / $25.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.22 / $19.05 / $27.54
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$12.02 / $12.02 / $14.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $20.89 / $28.18
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$9.12 / $12.02 / $17.78
Providence
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3.55 / $5.75 / $8.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.30 / $14.79 / $22.91
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$8.32 / $9.55 / $15.14
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$3.98 / $4.79 / $7.94