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Illinois 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 $324 · 10th–90th $182–$5750%10%10th90th$324Professionalmedian $151 · 10th–90th $4–$3550%10%20%10th90th$151$5.0$20.0$100.0$500.0$2.0K

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
$177.83 / $323.59 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $173.78 / $380.19
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $645.65 / $2,344.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3.47 / $128.82 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $398.11 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $223.87 / $316.23
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $323.59 / $831.76
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $338.84