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New Mexico 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
$281.44 / $562.88 / $1,125.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.44 / $450.30 / $2,412.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.91 / $243.91 / $243.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.12 / $452.61 / $622.47
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $611.66
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.91 / $375.25 / $472.82
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.56 / $454.05 / $540.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.61 / $157.61 / $225.15