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Maryland rates for HCPCS 84030

Phenylalanine (PKU), blood

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.90 / $112.90 / $135.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.91 / $4.13 / $6.79
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.46 / $5.08 / $8.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.92 / $3.81 / $7.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.92 / $5.84 / $9.14
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $6.88 / $8.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.61 / $4.15 / $50.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.48 / $3.30 / $5.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.15 / $2.75 / $5.40