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Montana rates for HCPCS A4364

Adhesive, liquid or equal, any type, per oz

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.47 / $10.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.41 / $3.41 / $3.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.66 / $3.66 / $3.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.10 / $3.66 / $3.66
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.62 / $3.49 / $3.91
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.75 / $2.83 / $4.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.57 / $1.75 / $1.99