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Wisconsin 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
$450.30 / $836.81 / $2,460.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.94 / $356.49 / $570.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$806.79 / $975.65 / $1,031.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.10 / $375.25 / $1,607.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$917.08 / $917.08 / $953.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,032.68 / $1,206.77 / $1,851.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.17 / $1,010.47 / $1,148.26
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.94 / $450.30 / $1,313.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.73 / $450.30 / $1,313.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.63 / $225.15 / $1,157.21
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $375.25
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.94 / $450.30 / $1,313.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.25 / $915.01 / $1,254.89
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.50 / $1,782.44 / $1,782.44
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.12 / $1,876.25 / $1,876.25
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.11 / $799.11 / $799.11
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.56 / $2,048.87 / $2,048.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.25 / $375.25 / $375.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.86 / $225.15 / $698.49