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Maine rates for HCPCS 81105

Human Platelet Antigen 1 genotyping (HPA-1), ITGB3 (integrin, beta 3 [platelet glycoprotein IIIa], antigen CD61 [GPIIIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant, HPA-1a/b (L33P)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $100.00 / $123.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $954.99 / $1,047.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $74.13 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $123.03 / $281.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $147.91
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $199.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $117.49 / $181.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $123.03 / $234.42