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Montana rates for HCPCS 96913

Photochemotherapy (Goeckerman and/or PUVA) for severe photoresponsive dermatoses requiring at least 4-8 hours of care under direct supervision of the physician (includes application of medication and dressings)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $186.21 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $208.93 / $295.12
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $263.03 / $295.12
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $263.03 / $295.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $165.96 / $288.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $186.21 / $295.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $223.87 / $263.03