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Utah rates for HCPCS 0256U

Trimethylamine/trimethylamine N-oxide (TMA/TMAO) profile, liquid chromatography tandem mass spectrometry (LC-MS/MS), urine, with algorithmic analysis and interpretive report

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $776.25 / $1,023.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.50 / $125.89 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $141.25 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $181.97 / $229.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $190.55 / $741.31
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $134.90 / $144.54
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $158.49 / $158.49
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $141.25 / $239.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $104.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $67.61 / $128.82