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Montana rates for HCPCS 87390

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; HIV-1

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.86 / $75.86 / $102.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $21.88 / $34.67
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.36 / $64,565.42 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $32.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $40.74 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $27.54 / $34.67
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $30.90 / $72.44
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.99 / $30.90 / $72.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $40.74 / $138.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $21.88 / $34.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $10.00 / $23.99