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Montana rates for HCPCS 87391

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-2

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.19 / $140.82 / $140.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29.35 / $68,099.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.76 / $42.71 / $64.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.08 / $31.49 / $31.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.64 / $37.22 / $64.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.71 / $19.71 / $31.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.19 / $9.19 / $24.25