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Indiana 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
$1,122.02 / $2,691.53 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,380.38 / $1,513.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $5,248.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $338.84 / $707.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $25,118.86 / $38,018.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $2,137.96 / $5,248.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,737.80 / $1,737.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $676.08 / $1,230.27