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Montana rates for HCPCS Q4155

Neoxflo Or Clarixflo 1 Mg

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.02 / $29.02 / $29.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.03 / $30.03 / $30.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.62 / $26.62 / $30.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.03 / $30.03 / $30.03
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.62 / $28.89 / $37.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.62 / $26.62 / $26.62