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Illinois rates for HCPCS 84081

Phosphatidylglycerol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.60 / $31.62 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $14.13 / $33.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.39 / $43.65 / $169.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.47 / $12.59 / $16.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $37.15 / $75.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.72 / $19.05 / $25.12
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $31.62 / $70.79
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.38 / $21.38 / $21.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.30 / $16.60 / $33.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.92 / $12.59 / $21.88