go back

Montana rates for HCPCS 80202

Vancomycin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.54 / $13.54 / $13.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.35 / $15.82 / $87.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.14 / $18.14 / $91,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.14 / $18.14 / $18.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.63 / $26.40 / $40.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.36 / $19.62 / $19.63
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.63 / $23.02 / $40.01
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.19 / $13.54 / $19.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.69 / $5.69 / $18.63