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New Jersey rates for HCPCS 81243

FMR1 (fragile X messenger ribonucleoprotein 1) (eg, fragile X syndrome, X-linked intellectual disability [XLID]) gene analysis; evaluation to detect abnormal (eg, expanded) alleles

Facilitymedian $95 · 10th–90th $58–$5010%10%20%10th90th$95Professionalmedian $71 · 10th–90th $29–$1000%20%10th90th$71$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
$57.54 / $87.10 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $70.79 / $100.00
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $151.36 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $125.89 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $60.26 / $125.89
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $60.26 / $107.15
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$57.54 / $10,471.29 / $25,118.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $57.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $57.54 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $33.88 / $61.66