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New Hampshire 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
$232.19 / $510.19 / $1,451.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.69 / $301.22 / $349.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.02 / $401.31 / $1,032.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.92 / $134.75 / $134.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$383.50 / $882.88 / $1,104.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.43 / $404.96 / $861.26
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.31 / $300.89 / $737.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.07 / $124.39 / $262.27
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.10 / $208.01 / $264.74