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Alaska rates for HCPCS 0254U

Reproductive medicine (preimplantation genetic assessment), analysis of 24 chromosomes using embryonic DNA genomic sequence analysis for aneuploidy, and a mitochondrial DNA score in euploid embryos, results reported as normal (euploidy), monosomy, trisomy, or partial deletion/duplication, mosaicism, and segmental aneuploidy, per embryo tested

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $5,888.44 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $707.95 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,089.30
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $3,630.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $2,454.71
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $2,818.38 / $3,019.95
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $1,698.24
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $2,089.30 / $3,630.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $1,513.56 / $2,290.87