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Montana rates for HCPCS 80200

Tobramycin

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $15.14 / $107.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $64,565.42 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $21.38 / $21.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $27.54 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $18.62 / $23.44
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.22 / $22.91 / $50.12
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.22 / $22.91 / $50.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.44 / $27.54 / $91.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $14.45 / $23.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.92 / $22.39