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Montana rates for HCPCS 0164U

Gastroenterology (irritable bowel syndrome [IBS]), immunoassay for anti-CdtB and anti-vinculin antibodies, utilizing plasma, algorithm for elevated or not elevated qualitative results

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $104.71 / $107.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $162.18 / $162.18
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.20 / $141.25 / $338.84
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $141.25 / $338.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $100.00 / $141.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.77 / $46.77 / $112.20