go back

Montana rates for HCPCS 81171

AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $128.82 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $234.42 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $199.53
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $186.21 / $416.87
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $186.21 / $416.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $234.42 / $776.25
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $123.03 / $218.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $138.04