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Montana rates for HCPCS 87420

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; respiratory syncytial virus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.62 / $148.62 / $231.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.84 / $11.67 / $64.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.64 / $18.64 / $91,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.64 / $18.64 / $18.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.87 / $41.10 / $79.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.17 / $16.11 / $20.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.43 / $27.12 / $41.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.52 / $12.52 / $17.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.84 / $6.85 / $23.82