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Montana rates for HCPCS 0170U

Neurology (autism spectrum disorder [ASD]), RNA, next-generation sequencing, saliva, algorithmic analysis, and results reported as predictive probability of ASD diagnosis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,018.25 / $2,018.25 / $2,018.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,827.50 / $2,827.50 / $2,827.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,827.50 / $2,827.50 / $2,827.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,827.50 / $2,827.50 / $2,827.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,579.50 / $1,579.50 / $2,808.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.10 / $737.10 / $1,755.00