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Utah 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
$199.53 / $512.86 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $199.53 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $223.87 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $309.03 / $537.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $776.25 / $1,202.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $234.42 / $281.84
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $177.83 / $281.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $223.87 / $380.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $107.15 / $151.36