go back

Montana rates for HCPCS G0404

Electrocardiogram, routine ECG with 12 leads; tracing only, without interpretation and report, performed as a screening for the initial preventive physical examination

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.61 / $10.48 / $45.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.99 / $9.99 / $9.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.65 / $9.23 / $11.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.82 / $9.99 / $15.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.76 / $14.16 / $18.00