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New Hampshire rates for HCPCS 87428

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; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$73.48 / $80.83 / $492.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.48 / $73.48 / $73.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.10 / $134.58 / $287.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.78 / $45.68 / $45.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.90 / $160.37 / $220.68
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.95 / $44.92 / $197.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.85 / $51.22 / $68.70
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.60 / $76.31 / $112.19