go back

Utah rates for HCPCS 87506

Infectious agent detection by nucleic acid (DNA or RNA); gastrointestinal pathogen (eg, Clostridium difficile, E. coli, Salmonella, Shigella, norovirus, Giardia), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 6-11 targets

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $1,023.29 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $204.17 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $229.09 / $724.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $302.00 / $478.63
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $724.44 / $1,258.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $263.03 / $309.03
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $186.21 / $263.03
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $229.09 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $123.03 / $158.49