go back

Indiana rates for HCPCS 81258

HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; known familial variant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.70 / $431.54 / $1,313.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.69 / $307.70 / $356.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.45 / $335.85 / $1,125.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.10 / $150.10 / $207.13
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.25 / $487.83 / $525.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.25 / $450.30 / $562.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.91 / $375.25 / $872.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.61 / $260.83 / $538.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.61 / $225.15 / $412.40