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Montana rates for HCPCS A4216

Sterile water, saline and/or dextrose, diluent/flush, 10 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.40 / $14.00 / $1,596.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.17 / $0.19 / $1.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.30 / $77,999.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.54 / $0.65 / $1.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.31 / $0.65 / $0.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.47 / $0.62 / $1.43
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.49 / $0.49 / $1.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.26 / $0.40