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Nebraska 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
$416.87 / $1,023.29 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $181.97 / $1,380.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $457.09 / $1,148.15
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $323.59 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $426.58 / $524.81
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $645.65 / $977.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $123.03 / $1,258.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $524.81 / $524.81
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $524.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.10 / $194.98 / $416.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $123.03 / $281.84