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Massachusetts 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 $372 · 10th–90th $112$5890%10%20%10th90th$372Professionalmedian $186 · 10th–90th $100$4570%20%10th90th$186$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$100.00 / $407.38 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $181.97 / $549.54
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $512.86 / $870.96
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $549.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $371.54 / $524.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $223.87 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $177.83 / $478.63
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $4,897.79 / $9,772.37
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $316.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $338.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $512.86 / $870.96
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $549.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $380.19