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Illinois rates for HCPCS G0416

Surgical Pathology Gross And Microscopic Examinations For Prostate Needle Biopsy Any Method (Revised 11/11/2014) Revised 1/1/2014

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.08 / $851.08 / $851.08
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$398.95 / $398.95 / $398.95
Aetna
Facility/Professional
Facility
Modifier
TC
Low / Median / High Price
$452.11 / $452.11 / $452.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.69 / $373.05 / $1,008.65
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$143.80 / $170.96 / $332.45
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$168.89 / $201.44 / $650.52
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.71 / $165.71 / $165.71
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$153.44 / $153.44 / $198.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.08 / $378.87 / $574.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.16 / $326.16 / $527.69
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$153.56 / $153.56 / $246.22
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$172.60 / $172.60 / $281.45
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.93 / $485.65 / $1,213.30
Hally Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$162.27 / $207.30 / $434.92
Hally Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$171.71 / $231.85 / $596.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $534.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.22 / $382.69 / $707.13
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$114.42 / $190.70 / $259.35
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$101.80 / $194.88 / $514.05