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Alaska rates for HCPCS 86756

Antibody; respiratory syncytial virus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.52 / $109.65 / $183.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.85 / $53.23 / $60.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.90 / $43.90 / $43.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.44 / $18.17 / $22.72
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.57 / $11.57 / $11.57
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.89 / $15.89 / $63.56
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.62 / $61.18 / $83.14
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.30 / $35.75 / $200.64
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.57 / $11.57 / $55.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.30 / $15.89 / $16.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.10 / $31.78 / $47.94