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Montana rates for HCPCS G0296

Counseling Visit To Discuss Need For Lung Cancer Screening (Ldct) Using Low Dose Ct Scan (Reinstated 01/01/16) Pet Imaging Full And Partial Ring Pet Scanner Only For Restaging Of Previously Treated Thyroid Cancer Of Follicular Cell Origin Following Negative I -131 Whole Body Scan (Deleted 4/1/2005)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.77 / $25.44 / $51.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68,099.99 / $68,099.99 / $81,499.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.10 / $39.44 / $43.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.44 / $39.44 / $43.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.70 / $39.44 / $43.97
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.46 / $26.83 / $79.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.49 / $47.50 / $69.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.65 / $48.00 / $55.99