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Utah 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
$72.44 / $323.59 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $72.44 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $61.66 / $194.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.02 / $54.95 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.30 / $30.90 / $134.90
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $60.26 / $97.72
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $74.13 / $81.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $34.67 / $48.98