go back

Maryland 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
Professional
Modifier
Low / Median / High Price
$243.91 / $277.69 / $281.44
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.20 / $300.20 / $342.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.45 / $231.83 / $922.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.25 / $450.30 / $562.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.61 / $168.86 / $236.41
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.63 / $187.63 / $187.63