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Montana rates for HCPCS 86787

Antibody; varicella-zoster

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.02 / $74.62 / $149.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.23 / $15.41 / $23.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.26 / $17.26 / $68,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.26 / $17.26 / $17.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.68 / $25.12 / $38.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.85 / $18.59 / $18.68
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.68 / $21.90 / $38.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.59 / $12.88 / $18.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.41 / $5.41 / $17.71