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Washington 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
$352.74 / $854.86 / $2,067.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.41 / $352.74 / $597.80
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.01 / $600.40 / $1,550.31
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.73 / $732.94 / $2,814.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.26 / $831.98 / $1,012.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.39 / $396.73 / $511.94
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$358.23 / $505.44 / $1,160.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.14 / $551.62 / $1,018.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $75.00 / $75.00
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.25 / $375.25 / $562.88
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.25 / $656.69 / $1,125.75
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.73 / $469.06 / $566.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$394.01 / $600.40 / $1,031.94
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.03 / $730.03 / $872.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.61 / $157.61 / $420.28