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Utah 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
$134.90 / $724.44 / $954.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $114.82 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $107.15 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $144.54 / $223.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $446.68 / $645.65
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $123.03 / $169.82
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $85.11 / $123.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $107.15 / $181.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $63.10 / $74.13