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Pennsylvania 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
$954.99 / $1,949.84 / $3,311.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $602.56 / $870.96
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,023.29 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $870.96 / $1,071.52
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $446.68 / $1,096.48
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $660.69 / $1,288.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,905.46 / $3,311.31
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $630.96 / $2,691.53
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $831.76 / $1,122.02
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $758.58 / $1,122.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $758.58 / $891.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $446.68 / $1,122.02