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Montana rates for HCPCS Q9957

Injection Perflutren Lipid Microspheres Per Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.80 / $493.48 / $2,226.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.64 / $44.72 / $154.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.81 / $47.81 / $142.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.65 / $45.44 / $49.59
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.72 / $61.79 / $142.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.10 / $49.10 / $57.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.65 / $40.65 / $40.65