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Utah rates for HCPCS 80076

Hepatic function panel This panel must include the following: Albumin (82040) Bilirubin, total (82247) Bilirubin, direct (82248) Phosphatase, alkaline (84075) Protein, total (84155) Transferase, alanine amino (ALT) (SGPT) (84460) Transferase, aspartate amino (AST) (SGOT) (84450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.48 / $52.48 / $144.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $6.61 / $8.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $8.51 / $54.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.13 / $9.55 / $15.85
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $29.51 / $43.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.62 / $6.92 / $7.41
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $8.13 / $8.13
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $8.13 / $15.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.75 / $4.07 / $5.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $4.79 / $11.22