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New Hampshire 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
Facility
Modifier
Low / Median / High Price
$136.88 / $300.77 / $855.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.33 / $105.62 / $122.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$201.05 / $236.59 / $608.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.89 / $79.44 / $79.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.09 / $461.86 / $631.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.37 / $232.30 / $507.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.22 / $177.39 / $434.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.33 / $73.33 / $122.22
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.49 / $133.79 / $196.67