go back

Arizona 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
$1,589.09 / $2,570.58 / $6,958.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$743.46 / $743.46 / $838.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,060.94 / $4,029.13 / $6,382.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.10 / $1,469.24 / $7,116.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$769.27 / $3,060.64 / $5,101.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,168.45 / $1,743.95 / $3,034.47
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.55 / $469.55 / $8,684.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$469.55 / $469.55 / $732.46