go back

New Hampshire rates for HCPCS 81313

PCA3/KLK3 (prostate cancer antigen 3 [non-protein coding]/kallikrein-related peptidase 3 [prostate specific antigen]) ratio (eg, prostate cancer)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $645.65 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $199.53 / $229.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $489.78 / $1,479.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $239.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $933.25 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $269.15 / $1,071.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $489.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $151.36 / $562.34