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Nebraska rates for HCPCS 87633

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, 12-25 targets

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.07 / $710.40 / $4,359.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.07 / $712.50 / $2,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.11 / $296.95 / $1,205.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.83 / $662.67 / $683.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,360.00 / $1,360.00 / $1,360.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.39 / $831.00 / $946.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$250.07 / $634.10 / $1,382.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.07 / $250.07 / $1,643.25
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.14 / $858.57 / $1,193.55
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$500.14 / $858.57 / $1,168.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.05 / $250.07 / $375.10