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Alaska rates for HCPCS G2025

Payment for a telehealth distant site service furnished by a Rural Health Clinic (RHC) or Federally Qualified Health Center (FQHC) only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.51 / $92.03 / $103.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.90 / $86.90 / $86.90
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.51 / $96.63 / $132.04
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.13 / $283.35 / $432.14
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.85 / $392.85 / $3,495.87
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.95 / $365.00 / $510.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.51 / $99.02 / $132.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.04 / $228.87 / $459.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.17 / $249.16 / $314.95