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Montana rates for HCPCS 0215U

Rare diseases (constitutional/heritable disorders), whole exome and mitochondrial DNA sequence analysis, including small sequence changes, deletions, duplications, short tandem repeat gene expansions, and variants in non-uniquely mappable regions, blood or saliva, identification and categorization of genetic variants, each comparator exome (eg, parent, sibling)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,398.83 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,311.31 / $7,762.47
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $3,311.31 / $7,762.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $3,715.35 / $5,623.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $2,290.87 / $3,715.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,071.52 / $2,570.40