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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
$3,153.10 / $5,238.21 / $8,899.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,542.82 / $2,542.82 / $2,542.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,096.87 / $2,096.87 / $2,096.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,636.23 / $3,636.23 / $3,636.23
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.05 / $759.05 / $2,444.14
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,808.49 / $2,808.49 / $3,036.20
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$683.15 / $1,707.86 / $1,707.86
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,096.87 / $2,922.34 / $3,636.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,087.39 / $2,087.39 / $2,087.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.05 / $1,518.10 / $2,290.21