go back

New Hampshire rates for HCPCS 0166U

Liver disease, 10 biochemical assays (a2-macroglobulin, haptoglobin, apolipoprotein A1, bilirubin, GGT, ALT, AST, triglycerides, cholesterol, fasting glucose) and biometric and demographic data, utilizing serum, algorithm reported as scores for fibrosis, necroinflammatory activity, and steatosis with a summary interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $3,548.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $354.81 / $407.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $954.99 / $2,884.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $323.59 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $1,584.89 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $724.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $870.96 / $1,621.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $302.00 / $776.25