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Vermont 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
Professional
Modifier
Low / Median / High Price
$129.69 / $129.69 / $657.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.16 / $171.16 / $171.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.48 / $229.48 / $229.48
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$171.16 / $171.16 / $171.16
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.47 / $66.47 / $229.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $102.26 / $236.26