go back

Utah rates for HCPCS 0265U

Rare constitutional and other heritable disorders, whole genome and mitochondrial DNA sequence analysis, blood, frozen and formalin-fixed paraffin-embedded (FFPE) tissue, saliva, buccal swabs or cell lines, identification of single nucleotide and copy number variants

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $26,302.68 / $34,673.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $4,897.79 / $6,918.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $4,786.30 / $15,135.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $25,703.96
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $4,677.35 / $5,495.41
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $3,801.89 / $5,495.41
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,786.30 / $8,128.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $3,311.31