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Scoliosis Progression Risk Score From Saliva

Kentucky rates for HCPCS 0004M

Estimates how likely a curve of the spine, known as scoliosis, is to get worse. It examines 53 inherited genetic markers in a saliva sample and combines them into a single risk score rather than reporting each marker separately.

Rates data updated July 2026.

How much does Scoliosis Progression Risk Score From Saliva cost?

$47.86

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $47.86 for this service. The price depends on where it is billed: about $31.62 from a physician practice, and about $115 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$31.62$31.62 to $63.10
FacilityA hospital or hospital-owned outpatient department$115$79.43 to $191

How much rates vary

Facilitymedian $115 · 10th to 90th $65 to $1,660Professionalmedian $32 · 10th to 90th $27 to $95
$100$1K$10Kfacility $115professional $32

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$97.72
Typical High
$190.55
Aetna
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$63.10
Typical High
$107.15
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$26.92
Median
$31.62
Typical High
$31.62
CareSource
Setting
Facility
Modifier
Global
Typical Low
$93.33
Median
$1,148.15
Typical High
$41,686.94
CareSource
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$109.65
Typical High
$1,479.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$61.66
Median
$114.82
Typical High
$186.21
Cigna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
Molina
Setting
Professional
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$95.50
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$47.86
Typical High
$79.43

Where Kentucky sits

The same service costs 4.3 times more in Alaska than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Kentucky· 50th of 51

$47.86

AK $178DE $41.69

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.