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Utah 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 / $539.70 / $1,242.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.28 / $236.69 / $236.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.79 / $231.19 / $724.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.89 / $281.62 / $481.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $60.00 / $60.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.99 / $302.44 / $1,065.10
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.77 / $265.76 / $315.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.46 / $110.46 / $157.79