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Montana rates for HCPCS 87633

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, 12-25 targets

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $489.78 / $1,548.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $1,445.44 / $91,201.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $812.83 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $630.96 / $1,318.26
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $630.96 / $1,318.26
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $707.95 / $2,398.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $660.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $416.87