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Alaska rates for HCPCS 84081

Phosphatidylglycerol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.55 / $117.49 / $204.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.88 / $15.85 / $54.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.71 / $45.71 / $45.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $19.05 / $23.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $17.78 / $17.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.60 / $16.60 / $66.07
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $63.10 / $107.15
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $37.15 / $37.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.78 / $17.78 / $17.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $16.60 / $21.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $33.11 / $50.12