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Indiana rates for HCPCS 81257

HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, Constant Spring)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.85 / $117.60 / $357.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.13 / $83.85 / $129.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.79 / $91.52 / $306.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.90 / $40.90 / $84.36
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.26 / $122.71 / $143.16
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.26 / $112.49 / $144.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.47 / $102.26 / $238.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.99 / $92.01 / $148.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.95 / $61.36 / $112.38