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Pennsylvania 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 $437 · 10th–90th $174$8710%10%10th90th$437Professionalmedian $151 · 10th–90th $100$3390%20%10th90th$151$50.0$200.0$1.0K$5.0K$20.0K

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
$173.78 / $457.09 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $398.11
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $223.87 / $4,168.69
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $891.25 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $302.00 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $199.53 / $416.87
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $165.96 / $251.19
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $239.88 / $407.38
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $501.19 / $1,348.96
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $194.98 / $446.68
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $281.84 / $630.96
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $275.42
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $173.78 / $489.78
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $173.78 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $186.21 / $223.87
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $245.47