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Arizona rates for HCPCS 81403

Molecular pathology procedure, Level 4 (eg, analysis of single exon by DNA sequence analysis, analysis of >10 amplicons using multiplex PCR in 2 or more independent reactions, mutation scanning or duplication/deletion variants of 2-5 exons)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.75 / $571.71 / $738.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $124.08 / $282.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$127.63 / $484.70 / $767.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.52 / $176.75 / $856.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$86.37 / $325.02 / $541.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.41 / $139.19 / $185.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$124.08 / $185.20 / $334.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.78 / $77.78 / $926.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.78 / $77.78 / $111.12