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Alaska rates for HCPCS 84375

Sugars, chromatographic, TLC or paper chromatography

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.72 / $269.14 / $457.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.65 / $130.65 / $250.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.74 / $107.74 / $107.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.34 / $45.02 / $56.27
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.40 / $28.40 / $28.40
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.00 / $39.00 / $156.00
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.84 / $144.30 / $156.00
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.10 / $87.75 / $87.75
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28.40 / $28.40 / $107.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.31 / $12.64 / $39.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.33 / $78.00 / $78.00