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Utah rates for HCPCS 87301

Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; adenovirus enteric types 40/41

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.19 / $79.59 / $104.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.86 / $9.82 / $15.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.24 / $10.54 / $33.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.48 / $13.63 / $17.04
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.98 / $13.78 / $53.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.17 / $9.76 / $13.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.03 / $7.09 / $7.19