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Vermont rates for HCPCS G0103

Prostate Cancer Screening; Prostate Specific Antigen Test (Psa)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.92 / $241.92 / $281.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.21 / $32.10 / $32.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.71 / $22.71 / $22.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.32 / $32.32 / $32.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.16 / $22.13 / $27.66
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.32 / $32.32 / $32.32
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.76 / $22.13 / $27.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.59 / $15.42 / $35.97