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Maine 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$150.00 / $248.36 / $463.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $150.01 / $277.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.22 / $272.24 / $1,970.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.08 / $74.08 / $248.53
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$395.03 / $395.03 / $395.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.27 / $187.57 / $195.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.20 / $185.20 / $187.05
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.20 / $185.20 / $827.84
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.03 / $185.20 / $202.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.60 / $111.12 / $277.80