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Kentucky 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 $257 · 10th–90th $151–$4470%10%20%10th90th$257Professionalmedian $151 · 10th–90th $74–$3090%10%10th90th$151$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$151.36 / $295.12 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $158.49 / $309.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $186.21 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $186.21
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $257.04 / $309.03
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $512.86 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $891.25 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $186.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $186.21