go back

New Jersey 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 $457 · 10th–90th $186–$3,0900%20%10th90th$457Professionalmedian $158 · 10th–90th $100–$3630%20%10th90th$158$100.0$500.0$2.0K$10.0K$50.0K

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
$213.80 / $457.09 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $158.49 / $398.11
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $489.78 / $5,623.41
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $407.38 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $199.53 / $407.38
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $194.98 / $354.81
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $10,471.29 / $25,118.86
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $186.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $186.21 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $194.98