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Utah 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
$457.09 / $2,454.71 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $398.11 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $446.68 / $1,380.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $724.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $44.67
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $602.56 / $2,344.23
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $426.58 / $457.09
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $446.68 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $323.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $213.80 / $407.38