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Montana rates for HCPCS 86689

Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $87.10 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.13 / $18.20 / $72.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $67.61 / $91,201.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $25.70 / $25.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $33.11 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.18 / $22.39 / $28.18
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.50 / $27.54 / $60.26
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $27.54 / $60.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.18 / $33.11 / $109.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $17.38 / $28.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $8.32 / $26.30