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New Hampshire rates for HCPCS 86363

Myelin oligodendrocyte glycoprotein (MOG-IgG1) antibody; flow cytometry (ie, fluorescence-activated cell sorting [FACS]), each

Facilitymedian $95 · 10th–90th $10–$6170%10%20%10th90th$95Professionalmedian $25 · 10th–90th $6–$710%10%10th90th$25$5.0$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
$9.77 / $95.50 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $8.91 / $28.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $72.44 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4.79 / $24.55 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$61.66 / $138.04 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.50 / $19.50 / $53.70
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $63.10 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $7.24 / $51.29