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Utah rates for HCPCS 86258

Gliadin (deamidated) (DGP) antibody, each immunoglobulin (Ig) class

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.38 / $75.86 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $10.23 / $20.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.23 / $10.47 / $33.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $16.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $8.91 / $8.91
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $34.67 / $54.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.13 / $10.23 / $10.72
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.51 / $12.02 / $38.02
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $10.72 / $18.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.03 / $6.03 / $7.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $4.79 / $9.12