go back

Montana rates for HCPCS 90396

Varicella-zoster immune globulin, human, for intramuscular use

Facilitymedian $178 · 10th–90th $138–$64,5650%20%40%10th90th$178Professionalmedian $2,344 · 10th–90th $178–$2,6920%50%10th90th$2,344$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $2,344.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $64,565.42 / $91,201.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $2,691.53 / $2,691.53
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $177.83 / $204.17
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $177.83 / $204.17
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $162.18
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $97.72 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,019.95