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Wisconsin rates for HCPCS 86258

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $104.71 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $16.98 / $30.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $32.36 / $33.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.57 / $4.57 / $40.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $29.51 / $30.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.02 / $12.02 / $12.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $38.90 / $61.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $16.98 / $38.02
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $39.81 / $67.61
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.31 / $14.45 / $125.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $7.24 / $20.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $17.78 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.49 / $28.18 / $39.81
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.99 / $23.99 / $60.26
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $5.75 / $6.17
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $11.48 / $24.55
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $69.18 / $79.43
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.48 / $33.88 / $66.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.12 / $9.12 / $14.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $7.24 / $23.44