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Texas 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 / $2,511.89 / $7,943.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,148.15 / $1,445.44
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $2,454.71 / $7,762.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $2,137.96 / $2,570.40
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $8,317.64 / $8,317.64
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,709.64 / $13,182.57 / $13,182.57
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,778.28 / $3,467.37
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,318.26 / $1,778.28
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,905.46 / $3,715.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,737.80 / $4,786.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $1,819.70 / $3,019.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $724.44 / $1,737.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $794.33
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $1,737.80 / $1,737.80