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California 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)

Facilitymedian $295 · 10th–90th $95$8710%5%10th90th$295Professionalmedian $204 · 10th–90th $100$5500%10%10th90th$204$10.0$50.0$200.0$1.0K$5.0K

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
$95.50 / $194.98 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $199.53 / $549.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $436.52 / $933.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $478.63
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $426.58 / $549.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $245.47 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $331.13 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $134.90 / $537.03
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $204.17 / $275.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $204.17 / $323.59
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,380.38 / $1,380.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $223.87 / $549.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $204.17 / $537.03
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $645.65
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $208.93 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $186.21 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $81.28 / $416.87