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Maine rates for HCPCS 81514

Infectious disease, bacterial vaginosis and vaginitis, quantitative real-time amplification of DNA markers for Gardnerella vaginalis, Atopobium vaginae, Megasphaera type 1, Bacterial Vaginosis Associated Bacteria-2 (BVAB-2), and Lactobacillus species (L. crispatus and L. jensenii), utilizing vaginal-fluid specimens, algorithm reported as a positive or negative for high likelihood of bacterial vaginosis, includes separate detection of Trichomonas vaginalis and/or Candida species (C. albicans, C. tropicalis, C. parapsilosis, C. dubliniensis), Candida glabrata, Candida krusei, when reported

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.99 / $262.99 / $657.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.02 / $213.02 / $262.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$254.50 / $386.60 / $1,881.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.20 / $105.20 / $249.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.37 / $266.13 / $336.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.99 / $262.99 / $265.62
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.99 / $262.99 / $657.48
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.02 / $262.99 / $262.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.79 / $157.79 / $394.49