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Montana rates for HCPCS 81109

Human Platelet Antigen 5 genotyping (HPA-5), ITGA2 (integrin, alpha 2 [CD49B, alpha 2 subunit of VLA-2 receptor] [GPIa]) (eg, neonatal alloimmune thrombocytopenia [NAIT], post-transfusion purpura), gene analysis, common variant (eg, HPA-5a/b (K505E))

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.55 / $785.88 / $785.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.22 / $207.77 / $696.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.28 / $177.22 / $177.22
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.22 / $207.77 / $696.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.00 / $110.00 / $177.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.33 / $51.33 / $122.22