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Utah rates for HCPCS 86053

Aquaporin-4 (neuromyelitis optica [NMO]) antibody; flow cytometry (ie, fluorescence-activated cell sorting [FACS]), each

Facilitymedian $59 · 10th–90th $10–$3160%20%10th90th$59Professionalmedian $10 · 10th–90th $7–$330%10%10th90th$10$10.0$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $75.86 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.00 / $32.36
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$32.36 / $39.81 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$17.78 / $43.65 / $53.70
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.33
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.02 / $43.65 / $48.98
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.70 / $32.36 / $33.88
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $38.02 / $42.66
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $33.11 / $38.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$19.05 / $19.05 / $24.55
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.01 / $5.01 / $22.39