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Montana rates for HCPCS P9604

Travel Allowance One Way In Connection With Medically Necessary Laboratory Specimen Collection Drawn From Home Bound Or Nursing Home Bound Patient; Prorated Trip Charge. (Special Coverage Instructions Apply. See Mcm: 51141k)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.49 / $8.49 / $11.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $16.30 / $16.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.75 / $4.69 / $16.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.30 / $16.30 / $16.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.24 / $5.39 / $16.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.30 / $16.05 / $19.00