go back

Montana rates for HCPCS 86756

Antibody; respiratory syncytial virus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.41 / $18.27 / $102.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.29 / $21.29 / $91,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.29 / $21.29 / $21.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.04 / $30.99 / $46.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.85 / $22.72 / $23.04
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.73 / $27.01 / $46.95
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.30 / $14.30 / $23.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.67 / $7.37 / $17.72