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Montana rates for HCPCS 90958

End-stage renal disease (ESRD) related services monthly, for patients 12-19 years of age to include monitoring for the adequacy of nutrition, assessment of growth and development, and counseling of parents; with 2-3 face-to-face visits by a physician or other qualified health care professional per month

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.58 / $439.11 / $699.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$780.29 / $780.29 / $780.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.46 / $576.44 / $1,204.75
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$468.20 / $577.80 / $990.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$541.33 / $921.88 / $1,333.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.20 / $713.40 / $832.80