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Georgia 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 $245 · 10th–90th $129–$6170%10%10th90th$245Professionalmedian $174 · 10th–90th $100–$3720%20%10th90th$174$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
$128.82 / $338.84 / $616.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $173.78 / $371.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $213.80 / $257.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $74.13 / $371.54
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $257.04 / $398.11
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $239.88 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $302.00 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $190.55 / $588.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $239.88 / $1,445.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $229.09 / $398.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $263.03