Phenylalanine blood test for PKU

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC NEWBORN PHENYLETONURIA SCREEN

Payers reporting CPT 84030

Payer pricing summary

Low

Average

$44

Median

$28

High

$204

Payer rate distribution

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#
1	Molina fee schedule · outpatient · +27 other terms	282	$6	$7	$9	119%	16–43	$1 – $184
2	Premera fee schedule · outpatient · +7 other terms	19	$7	$12	$30	245%	14–23	$6 – $241
3	UnitedHealthcare fee schedule · outpatient · +28 other terms	730	$6	$8	$14	180%	3–30	$1 – $299
4	Anthem fee schedule · outpatient · +20 other terms	181	$8	$13	$16	119%	3–30	$1 – $271
5	Bcbs Al other · outpatient · +4 other terms	2	$10	$9	$4	48%	2–20	$6 – $15
6	Aetna fee schedule · outpatient · +24 other terms	680	$7	$41	$363	875%	1–10	$0 – $8.4k
7	Cigna fee schedule · outpatient · +21 other terms	461	$11	$16	$21	136%	1–10	$3 – $362
8	Aetna Better Health fee schedule · outpatient · +17 other terms	97	$5	$5	$0	7%	1–10	$3 – $6
9	Humana fee schedule · outpatient · +24 other terms	499	$6	$14	$20	139%	—	$1 – $246
10	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	470	$8	$15	$16	104%	—	$1 – $124
11	WellCare fee schedule · outpatient · +16 other terms	296	$6	$7	$4	64%	—	$4 – $59
12	Devoted fee schedule · outpatient · +12 other terms	189	$6	$6	$0	3%	—	$5 – $6
13	Oscar fee schedule · outpatient · +17 other terms	163	$11	$12	$4	34%	—	$5 – $17
14	Cigna Healthspring fee schedule · outpatient · +6 other terms	140	$6	$6	$1	11%	—	$3 – $9
15	Ambetter facility · fee schedule · outpatient · +16 other terms	107	$10	$10	$2	23%	—	$6 – $14
16	Caresource fee schedule · outpatient · +13 other terms	91	$6	$10	$13	124%	—	$1 – $104
17	Kaiser fee schedule · outpatient · +17 other terms	90	$6	$9	$15	173%	—	$4 – $152
18	Optum fee schedule · outpatient · +15 other terms	71	$6	$7	$3	39%	—	$5 – $16
19	MultiPlan fee schedule · outpatient · +16 other terms	69	$92	$68	$75	111%	—	$1 – $433
20	Tricare fee schedule · outpatient · +15 other terms	60	$6	$6	$0	5%	—	$4 – $6
21	Superior Healthplan fee schedule · outpatient · +5 other terms	59	$6	$40	$36	91%	—	$5 – $94
22	Medicaid facility · fee schedule · outpatient · +13 other terms	53	$6	$6	$1	24%	—	$5 – $13
23	Amerihealth Caritas fee schedule · outpatient · +12 other terms	49	$6	$6	$3	42%	—	$1 – $19
24	Medicare facility · fee schedule · outpatient · +12 other terms	46	$5	$11	$26	227%	—	$5 – $171
25	Clover fee schedule · outpatient · +7 other terms	44	$6	$6	$0	2%	—	$6 – $6

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