go back

New Hampshire 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
$420.28 / $923.49 / $2,626.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.68 / $262.68 / $303.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$617.29 / $726.41 / $1,868.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.10 / $243.91 / $243.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.17 / $1,418.09 / $1,619.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.32 / $577.70 / $1,559.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.25 / $544.64 / $1,236.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.61 / $225.15 / $375.25
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.26 / $304.99 / $388.16