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Wisconsin rates for HCPCS 0170U

Neurology (autism spectrum disorder [ASD]), RNA, next-generation sequencing, saliva, algorithmic analysis, and results reported as predictive probability of ASD diagnosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $5,370.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,445.44 / $1,659.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $338.84 / $6,606.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $6,309.57 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $4,466.84 / $6,025.60
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $7,413.10 / $11,220.18
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $12,882.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $2,344.23 / $6,760.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,047.13 / $9,772.37
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $4,570.88 / $6,456.54
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $9,332.54 / $9,332.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $7,762.47 / $9,772.37
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $10,715.19 / $13,489.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $2,344.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,047.13 / $2,884.03