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Montana rates for HCPCS 87255

Virus Id Non-Immunologic Oth/Thn Cytopathic

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.25 / $78.40 / $112.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.52 / $30.71 / $217.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.37 / $45.37 / $91,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.37 / $45.37 / $45.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.10 / $66.03 / $100.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.31 / $49.04 / $49.10
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.10 / $57.56 / $100.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.47 / $33.86 / $49.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.22 / $14.22 / $46.55