go back

New Hampshire rates for HCPCS 86363

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.77 / $95.50 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $8.91 / $28.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.91 / $72.44 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $24.55 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $117.49 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $19.50 / $53.70
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $63.10 / $72.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.24 / $7.24 / $40.74