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Ohio 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 $257 · 10th–90th $148$6760%10%20%10th90th$257Professionalmedian $151 · 10th–90th $87$3980%10%20%10th90th$151$5.0$20.0$100.0$500.0$2.0K$10.0K

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 / $275.42 / $676.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $446.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $194.98 / $338.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $95.50 / $251.19
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $213.80 / $257.04
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $223.87 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $245.47 / $1,071.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $162.18 / $371.54
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $1,071.52
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $100.00 / $416.87
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $165.96 / $229.09
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $223.87
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $208.93 / $426.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $186.21 / $275.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $269.15