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Alaska rates for HCPCS 0003M

Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algorithm reported as quantitative scores for fibrosis, steatosis and nonalcoholic steatohepatitis (NASH)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $3,890.45 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $467.74 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $660.69
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $416.87 / $2,290.87
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $1,513.56 / $1,698.24
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $1,862.09 / $1,995.26
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $1,122.02 / $1,122.02
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $407.38 / $912.01
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $457.09 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $1,000.00 / $1,513.56