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Montana rates for HCPCS 96112

Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.57 / $126.53 / $177.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $64,999.99 / $89,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.92 / $166.26 / $195.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.02 / $195.60 / $392.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.00 / $166.26 / $507.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.99 / $137.97 / $195.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.37 / $170.95 / $293.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.39 / $214.48 / $280.77