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North Carolina 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 $282 · 10th–90th $148–$8320%10%10th90th$282Professionalmedian $170 · 10th–90th $107–$3390%10%20%10th90th$170$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
$147.91 / $281.84 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $158.49 / $302.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$407.38 / $489.78 / $588.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $251.19 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $407.38 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $87.10 / $251.19
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $165.96 / $288.40
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $194.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $218.78 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $239.88
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $1,380.38