go back

Pennsylvania 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
$1,479.11 / $5,128.61 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,230.27 / $1,479.11
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $2,398.83 / $5,248.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,317.64 / $8,317.64 / $8,317.64
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,344.23 / $3,801.89
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,778.28 / $3,090.30
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $5,128.61 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,412.54 / $4,365.16
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,905.46
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $2,089.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $676.08 / $1,737.80