go back

Montana rates for HCPCS 86654

Antibody Encephalitis Westrn Equine

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.17 / $84.81 / $84.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.13 / $25.72 / $38.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.02 / $19.10 / $19.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.13 / $22.42 / $38.97
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.87 / $13.19 / $19.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.54 / $5.54 / $18.13