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Montana rates for HCPCS G2025

Payment for a telehealth distant site service furnished by a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.27 / $98.27 / $98.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.03 / $93.25 / $103.44
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
$153.01 / $153.01 / $153.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.01 / $153.01 / $153.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.90 / $86.90 / $153.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$92.03 / $99.05 / $153.01
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.04 / $151.52 / $243.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.40 / $145.35 / $168.30