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Montana rates for HCPCS 84252

Riboflavin (Vitamin B-2)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.65 / $120.65 / $120.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.64 / $18.22 / $130.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.12 / $27.12 / $91,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.12 / $27.12 / $27.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.35 / $39.47 / $59.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.95 / $29.35 / $29.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.35 / $34.40 / $59.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.22 / $20.23 / $29.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.50 / $8.50 / $27.82