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Montana rates for HCPCS 90284

Immune Globulin Human Subq Infusion 100 Mg Ea

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.89 / $15.17 / $15.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.64 / $16.64 / $16.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.64 / $16.64 / $17.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.30 / $17.30 / $18.38