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Utah rates for HCPCS 81172

AFF2 (ALF transcription elongation factor 2 [FMR2]) (eg, fragile X intellectual disability 2 [FRAXE]) gene analysis; characterization of alleles (eg, expanded size and methylation status)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $1,318.26 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $245.47 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $239.88 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $295.12 / $501.19
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $831.76 / $1,318.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $263.03 / $309.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $275.42
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $239.88 / $407.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $165.96