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Maine 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
$24.64 / $102.26 / $217.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.83 / $82.83 / $140.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.96 / $150.32 / $806.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.90 / $40.90 / $101.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.12 / $218.12 / $218.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.69 / $103.44 / $107.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.26 / $102.26 / $103.28
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.26 / $102.26 / $448.81
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.83 / $102.26 / $134.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.15 / $61.36 / $178.96