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Montana rates for HCPCS 80155

Drug Assay Caffeine

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.36 / $248.01 / $248.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.93 / $75.20 / $113.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.19 / $55.24 / $55.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.93 / $75.20 / $113.97
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.71 / $34.71 / $55.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.11 / $16.20 / $38.57