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Montana rates for HCPCS G0475

Hiv Antigen/Antibody Combination Assay Screening

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.51 / $217.51 / $217.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.69 / $27.69 / $27.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.27 / $68,099.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.27 / $32.27 / $32.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.13 / $25.13 / $31.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.67 / $24.08 / $30.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.11 / $10.11 / $33.03