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Montana rates for HCPCS 86304

Immunoassay Tumor Antigen Quantitative Ca 125

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.26 / $118.37 / $282.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.01 / $24.30 / $31.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.89 / $27.89 / $91,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.89 / $27.89 / $27.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.17 / $40.58 / $61.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.29 / $29.94 / $30.17
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.17 / $35.38 / $61.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.73 / $20.81 / $30.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.74 / $8.74 / $28.61