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Pennsylvania rates for HCPCS 87425

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; rotavirus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.17 / $47.64 / $74.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.58 / $10.71 / $19.60
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.54 / $72.12 / $8,639.91
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.34 / $9.34 / $9.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.88 / $15.96 / $40.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.46 / $13.63 / $21.16
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.51 / $9.58 / $16.22
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.45 / $38.58 / $70.00
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.19 / $10.50 / $10.50
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.18 / $35.63 / $77.26
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.34 / $10.79 / $58.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.02 / $18.22 / $40.20
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.46 / $13.63 / $21.16
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.98 / $11.98 / $11.98
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.54 / $11.98 / $15.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.39 / $7.43 / $21.92