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Utah 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
$100.00 / $100.00 / $375.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $233.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.30 / $162.81 / $510.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.14 / $198.79 / $339.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.20 / $212.98 / $750.06
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.66 / $199.66 / $221.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.78 / $77.78 / $185.20