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Alaska rates for HCPCS 0103U

Hereditary ovarian cancer (eg, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of NGS, Sanger, MLPA, and array CGH, with mRNA analytics to resolve variants of unknown significance when indicated (24 genes [sequencing and deletion/duplication], EPCAM [deletion/duplication only])

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $13,489.63 / $21,379.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $4,786.30
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $5,888.44 / $12,589.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $5,248.07 / $5,623.41
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $6,456.54 / $6,918.31
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $4,786.30 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $2,238.72 / $3,388.44