go back

Tennessee 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)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.90 / $157.05 / $583.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.16 / $144.46 / $210.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.20 / $235.00 / $364.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.83 / $408.53 / $580.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.36 / $127.60 / $500.90
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.25 / $879.70 / $879.70
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$926.00 / $926.00 / $1,389.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.78 / $111.12 / $185.20