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Maine rates for HCPCS 81316

PML/RARalpha, (t(15;17)), (promyelocytic leukemia/retinoic acid receptor alpha) (eg, promyelocytic leukemia) translocation analysis; single breakpoint (eg, intron 3, intron 6 or exon 6), qualitative or quantitative

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.31 / $207.31 / $518.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.92 / $167.92 / $207.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.61 / $304.75 / $716.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.92 / $82.92 / $408.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.18 / $442.18 / $442.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.85 / $209.83 / $219.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.31 / $207.31 / $209.38
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.31 / $207.31 / $518.28
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.92 / $207.31 / $207.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.39 / $215.70 / $646.11