go back

Utah rates for HCPCS 86804

Hepatitis C antibody; confirmatory test (eg, immunoblot)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.05 / $104.71 / $138.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.00 / $12.02 / $19.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.18 / $13.49 / $42.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.77 / $17.78 / $29.51
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.49 / $56.23 / $81.28
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $13.18 / $13.80
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.96 / $15.49 / $48.98
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $15.49 / $23.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.76 / $7.76 / $10.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.46 / $9.12 / $21.38