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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
$758.58 / $758.58 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $575.44 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $457.09 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $912.01
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $588.84 / $741.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $758.58 / $1,096.48