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Vermont 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
$263.03 / $316.23 / $467.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $398.11 / $562.34
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $371.54 / $371.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $371.54 / $870.96