go back

Montana rates for HCPCS 87631

Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $363.08 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $151.36 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $64,565.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $275.42 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $89.13 / $89.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $177.83 / $436.52
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $177.83 / $436.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.89 / $275.42 / $812.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $229.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $141.25