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Montana rates for HCPCS A5126

Adhesive or nonadhesive; disk or foam pad

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.57 / $4.48 / $4.48
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.79 / $1.79 / $1.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.10 / $1.92 / $1.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.92 / $1.92
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.90 / $1.83 / $1.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.44 / $1.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.71 / $0.77 / $0.91