go back

Montana 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
$285.02 / $285.02 / $805.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $312.45 / $1,190.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.17 / $1,141.30 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.17 / $248.17 / $248.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.54 / $314.83 / $1,055.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.54 / $268.54 / $268.54
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.54 / $314.83 / $1,055.64
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.68 / $166.68 / $268.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.78 / $77.78 / $185.20