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Utah rates for HCPCS 0004M

Scoliosis, DNA analysis of 53 single nucleotide polymorphisms (SNPs), using saliva, prognostic algorithm reported as a risk score

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.79 / $380.19 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.66 / $70.79 / $100.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$67.61 / $69.18 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $95.50 / $95.50
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $144.54 / $380.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $75.86 / $89.13
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $54.95 / $79.43
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $69.18 / $117.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $47.86