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Montana rates for HCPCS A4634

Replacement bulb for therapeutic light box, tabletop model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $158.49 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.12 / $25.12 / $25.12
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.85 / $158.49 / $281.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $79.43 / $85.11