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Scoliosis Progression Risk Score From Saliva

New York 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?

$67.61

Typical negotiated rate. In New York, July 2026.

Insurers have agreed to pay about $67.61 for this service. The price depends on where it is billed: about $43.65 from a physician practice, and about $138 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 9 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$43.65$31.62 to $67.61
FacilityA hospital or hospital-owned outpatient department$138$83.18 to $186

How much rates vary

Facilitymedian $138 · 10th to 90th $65 to $224Professionalmedian $44 · 10th to 90th $32 to $112
$0.1$1$10$100facility $138professional $44

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
$54.95
Median
$141.25
Typical High
$218.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$54.95
Typical High
$67.61
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$31.62
Median
$31.62
Typical High
$114.82
CDPHP
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
CDPHP
Setting
Professional
Modifier
Global
Typical Low
$57.54
Median
$79.43
Typical High
$79.43
Cigna
Setting
Facility
Modifier
Global
Typical Low
$77.62
Median
$77.62
Typical High
$194.98
Cigna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$380.19
Typical High
$380.19
Emblem Health
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$131.83
Typical High
$302.00
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$83.18
Median
$102.33
Typical High
$154.88
Excellus BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$75.86
Typical High
$141.25
MVP Health Care
Setting
Facility
Modifier
Global
Typical Low
$102.33
Median
$147.91
Typical High
$50,118.72
MVP Health Care
Setting
Professional
Modifier
Global
Typical Low
$58.88
Median
$79.43
Typical High
$141.25
United
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$223.87
Typical High
$676.08
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$47.86
Typical High
$107.15
Univera
Setting
Facility
Modifier
Global
Typical Low
$47.86
Median
$79.43
Typical High
$91.20
Univera
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$79.43
Typical High
$190.55

Where New York 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.

New York· 34th of 51

$67.61

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.