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New York 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 $347 · 10th–90th $186–$6030%10%20%10th90th$347Professionalmedian $158 · 10th–90th $74–$3390%10%10th90th$158$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

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
$186.21 / $346.74 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $173.78 / $363.08
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $478.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $281.84
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $186.21
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $186.21 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $398.11 / $660.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $251.19 / $891.25
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $398.11 / $676.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $354.81
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $177.83 / $331.13
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $208.93 / $2,089.30
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $346.74 / $50,118.72
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $190.55
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $128.82 / $416.87
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $194.98 / $588.84
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $177.83 / $588.84