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Pennsylvania rates for HCPCS 81161

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

Facilitymedian $759 · 10th–90th $251–$1,3180%10%20%10th90th$759Professionalmedian $229 · 10th–90th $155–$8320%20%40%10th90th$229$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$263.03 / $758.58 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $229.09 / $831.76
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $436.52 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $263.03 / $630.96
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $251.19 / $380.19
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $467.74 / $707.95
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$281.84 / $281.84 / $281.84
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $812.83 / $1,698.24
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $223.87 / $831.76
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $281.84 / $380.19
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $281.84 / $380.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $281.84 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $165.96 / $346.74