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Pennsylvania rates for HCPCS 87389

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; HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.36 / $79.95 / $158.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $20.47 / $35.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.82 / $14.45 / $39.72
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.56 / $70.05 / $278.32
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.65 / $15.65 / $15.65
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.85 / $153.03 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.78 / $18.78 / $18.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.12 / $31.30 / $69.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.07 / $27.67 / $42.31
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.08 / $18.67 / $32.60
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.92 / $62.78 / $125.07
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.45 / $20.29 / $39.57
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.56 / $66.09 / $150.88
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.65 / $15.65 / $15.65
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24.60 / $80.64 / $171.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.65 / $20.99 / $36.11
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.17 / $217.15 / $302.08
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.12 / $36.60 / $80.41
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.07 / $27.67 / $42.31
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30.79 / $30.79 / $30.79
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.79 / $30.79 / $30.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.84 / $16.80 / $44.07