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Montana rates for HCPCS 76965

Us Guidance Interstitial Radioelment Application

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.87 / $114.67 / $154.57
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$58.95 / $62.65 / $106.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.16 / $105.16 / $148.80
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$105.16 / $105.16 / $130.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.83 / $148.80 / $233.53
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.66 / $105.16 / $132.13
Providence
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$105.16 / $105.16 / $130.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.15 / $132.49 / $191.10
Providence
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$66.66 / $105.16 / $132.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.28 / $129.79 / $204.92
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.31 / $69.65 / $158.26