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Montana 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
$431.54 / $2,412.86 / $2,412.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$544.11 / $637.92 / $2,138.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.26 / $544.11 / $544.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$544.11 / $637.92 / $2,138.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.73 / $337.73 / $544.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.61 / $157.61 / $375.25