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Montana rates for HCPCS 87350

Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; hepatitis Be antigen (HBeAg)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.77 / $48.98 / $89.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $10.00 / $75.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $39.81 / $91,201.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $15.49 / $15.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $19.50 / $66.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $13.18 / $16.60
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $15.49 / $34.67
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $15.49 / $34.67
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14.13 / $19.50 / $66.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $10.47 / $16.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $5.01 / $15.85