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Montana rates for HCPCS 96376

Ther Proph/Dx Njx Ea Seql Iv Push Sbst/Drug Fac

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.30 / $221.85 / $552.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.36 / $11.36 / $11.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.70 / $34.70 / $34.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.25 / $15.25 / $18.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.86 / $13.86 / $31.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.25 / $15.25 / $18.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.71 / $13.86 / $21.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.57 / $16.53 / $23.37