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Montana rates for HCPCS 81596

Infectious disease, chronic hepatitis C virus (HCV) infection, six biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, and haptoglobin) utilizing serum, prognostic algorithm reported as scores for fibrosis and necroinflammatory activity in liver

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $363.08 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $67.61 / $239.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $251.19 / $91,201.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $97.72 / $97.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $123.03 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $83.18 / $104.71
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.44 / $97.72 / $218.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $97.72 / $218.78
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $123.03 / $407.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $104.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $72.44