go back

Pennsylvania rates for HCPCS 0003M

Liver disease, ten biochemical assays (ALT, A2-macroglobulin, apolipoprotein A-1, total bilirubin, GGT, haptoglobin, AST, glucose, total cholesterol and triglycerides) utilizing serum, prognostic algorithm reported as quantitative scores for fibrosis, steatosis and nonalcoholic steatohepatitis (NASH)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $1,258.93 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $407.38 / $562.34
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,398.83 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $776.25 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $660.69
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $295.12 / $724.44
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $501.19 / $870.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $741.31 / $891.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,258.93 / $2,089.30
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $407.38 / $1,258.93
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $549.54 / $549.54
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $524.81 / $645.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $501.19 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $302.00 / $758.58