go back

Montana rates for HCPCS A4772

Blood Glucose Test Strips For Dialysis Per 50 (Special Coverage Instructions Apply. See Mcm: 4270)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.91 / $13.12 / $18.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.87 / $27.87 / $27.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.57 / $14.57 / $27.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.03 / $23.48 / $32.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.57 / $27.87 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.40 / $11.48 / $18.98