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Scoliosis Progression Risk Score From Saliva

Pennsylvania 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?

$64.57

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $64.57 for this service. The price depends on where it is billed: about $63.10 from a physician practice, and about $129 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$63.10$47.86 to $67.61
FacilityA hospital or hospital-owned outpatient department$129$83.18 to $200

How much rates vary

Facilitymedian $129 · 10th to 90th $68 to $282Professionalmedian $63 · 10th to 90th $42 to $87
$50$100$200$500$1K$2K$5Kfacility $129professional $63

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
$67.61
Median
$151.36
Typical High
$281.84
Aetna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$63.10
Typical High
$67.61
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$8,511.38
Typical High
$77,624.71
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$61.66
Median
$61.66
Typical High
$61.66
Cigna
Setting
Facility
Modifier
Global
Typical Low
$56.23
Median
$107.15
Typical High
$269.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$380.19
Median
$380.19
Typical High
$380.19
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$102.33
Typical High
$112.20
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$79.43
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$131.83
Typical High
$199.53
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$151.36
Typical High
$281.84
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$64.57
Typical High
$120.23
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$114.82
Median
$117.49
Typical High
$158.49
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$194.98
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$79.43
Typical High
$81.28
United
Setting
Professional
Modifier
Global
Typical Low
$33.11
Median
$47.86
Typical High
$104.71

Where Pennsylvania 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.

Pennsylvania· 38th of 51

$64.57

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.