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Montana rates for HCPCS 99394

Periodic comprehensive preventive medicine reevaluation and management of an individual including an age and gender appropriate history, examination, counseling/anticipatory guidance/risk factor reduction interventions, and the ordering of laboratory/diagnostic procedures, established patient; adolescent (age 12 through 17 years)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.75 / $102.56 / $387.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68,099.99 / $68,099.99 / $81,499.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.35 / $129.35 / $179.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.95 / $129.35 / $179.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.77 / $143.16 / $192.27
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.81 / $108.07 / $177.73
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.70 / $177.37 / $269.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.63 / $181.51 / $215.16