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Michigan 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 $224 · 10th–90th $178–$4070%20%10th90th$224Professionalmedian $174 · 10th–90th $100–$3160%10%10th90th$174$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
$177.83 / $223.87 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $173.78 / $338.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $208.93 / $371.54
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $190.55 / $446.68
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $239.88 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $186.21 / $257.04
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $186.21 / $323.59
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $162.18 / $275.42
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $186.21 / $416.87
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