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Louisiana 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
$1,174.90 / $1,905.46 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,174.90 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $2,187.76 / $3,467.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $602.56
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $2,041.74 / $13,182.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,122.02 / $1,737.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $562.34 / $1,621.81