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Utah rates for HCPCS 0333U

Oncology (liver), surveillance for hepatocellular carcinoma (HCC) in high-risk patients, analysis of methylation patterns on circulating cell-free DNA (cfDNA) plus measurement of serum of AFP/AFP-L3 and oncoprotein des-gamma-carboxy-prothrombin (DCP), algorithm reported as normal or abnormal result

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $3,235.94 / $4,168.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $602.56 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $588.84 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $79.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $660.69
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $660.69
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $588.84 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $398.11