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Montana rates for HCPCS G0103

Prostate cancer screening; prostate specific antigen test (PSA)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.23 / $123.36 / $176.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.30 / $22.01 / $91.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.88 / $25.88 / $68,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.88 / $25.88 / $25.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.00 / $37.65 / $57.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.13 / $27.66 / $28.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.00 / $32.83 / $57.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.38 / $19.30 / $28.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.11 / $8.11 / $25.29