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Montana rates for HCPCS 86053

Aquaporin-4 (neuromyelitis optica [NMO]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [FACS]), each

Facilitymedian $49 · 10th–90th $15–$1320%10%20%10th90th$49Professionalmedian $13 · 10th–90th $10–$1170%20%10th90th$13$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $10.96 / $251.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $66.07 / $87,096.36
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $53.70 / $54.95
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.02 / $46.77 / $114.82
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.02 / $46.77 / $114.82
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.96 / $46.77 / $79.43
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $38.02 / $38.02
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $15.85