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Montana rates for HCPCS 87290

Iaadi Varicella Zoster Virus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.43 / $86.29 / $86.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.98 / $68,099.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $17.98 / $17.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.46 / $26.17 / $39.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.17 / $19.10 / $19.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.43 / $22.81 / $39.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.08 / $12.08 / $19.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.42 / $13.42 / $13.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.64 / $6.85 / $16.48