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Utah rates for HCPCS 87631

Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes, 3-5 targets

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $323.59 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $134.90 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $125.89 / $389.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $181.97 / $302.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $436.52 / $676.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $141.25 / $186.21
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $138.04 / $147.91
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $141.25 / $263.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $74.13 / $85.11