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Maine rates for HCPCS 0247U

Obstetrics (preterm birth), insulin-like growth factor-binding protein 4 (IBP4), sex hormone-binding globulin (SHBG), quantitative measurement by LC-MS/MS, utilizing maternal serum, combined with clinical data, reported as predictive-risk stratification for spontaneous preterm birth

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.00 / $750.00 / $1,593.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.00 / $750.00 / $750.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,156.20 / $4,798.05 / $5,592.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.00 / $300.00 / $637.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.93 / $861.93 / $1,077.41
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.00 / $750.00 / $908.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.00 / $750.00 / $1,215.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$750.00 / $750.00 / $750.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.00 / $450.00 / $1,087.50