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Maine 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
$759.05 / $759.05 / $1,612.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.83 / $614.83 / $614.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.43 / $500.00 / $500.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.05 / $759.05 / $766.64
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$759.05 / $759.05 / $1,229.66
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.83 / $614.83 / $759.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.12 / $455.43 / $1,328.34