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Vermont 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
Professional
Modifier
Low / Median / High Price
$8.91 / $10.00 / $19.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $114.82 / $204.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.95 / $19.95 / $19.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.32 / $13.49 / $18.62
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.02 / $12.02 / $12.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.25 / $10.00 / $32.36