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New York rates for HCPCS 81161

DMD (dystrophin) (eg, Duchenne/Becker muscular dystrophy) deletion analysis, and duplication analysis, if performed

Facilitymedian $490 · 10th–90th $224$8320%10%20%10th90th$490Professionalmedian $224 · 10th–90th $112$5250%10%10th90th$224$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $489.78 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $234.42 / $831.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $724.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $407.38
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $281.84 / $281.84
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $281.84 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $602.56 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $338.84 / $1,348.96
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $457.09 / $1,071.52
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $524.81
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $169.82
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $263.03 / $331.13
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $524.81 / $50,118.72
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $281.84 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $169.82 / $426.58
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $177.83 / $295.12
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $263.03 / $549.54