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New Mexico 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
$5,248.07 / $5,754.40 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,174.90 / $1,412.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,122.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $3,715.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,737.80 / $5,128.61
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,905.46 / $2,511.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $676.08