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Pennsylvania 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
$82.83 / $289.91 / $447.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.81 / $86.92 / $258.14
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$353.20 / $470.65 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.76 / $79.76 / $79.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.05 / $150.91 / $339.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.14 / $109.30 / $231.06
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.84 / $138.05 / $194.29
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$134.72 / $181.91 / $555.38
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.92 / $278.07 / $456.39
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.79 / $134.93 / $422.33
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.79 / $571.79 / $719.37
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.34 / $153.38 / $521.60
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.49 / $170.13 / $339.02
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.43 / $109.36 / $231.06
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.26 / $102.26 / $180.04
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.26 / $102.26 / $180.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.95 / $61.36 / $143.16