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Indiana rates for HCPCS 84081

Phosphatidylglycerol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.55 / $19.00 / $60.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.05 / $13.55 / $15.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.05 / $15.75 / $49.56
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.16 / $8.16 / $12.24
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.52 / $19.82 / $22.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.52 / $19.00 / $23.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.09 / $16.52 / $42.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.88 / $19.00 / $47.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.58 / $78.58 / $78.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.94 / $13.16 / $18.17