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Wisconsin 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 $457 · 10th–90th $224–$7760%10%10th90th$457Professionalmedian $186 · 10th–90th $74–$5890%5%10%10th90th$186$5.0$20.0$100.0$500.0$2.0K

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
$223.87 / $416.87 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $173.78 / $398.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $501.19 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $74.13 / $741.31
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $275.42
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $602.56 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $575.44
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $776.25 / $1,174.90
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,230.27
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $645.65
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $112.20 / $575.44
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $64.57 / $186.21
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $223.87 / $524.81
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $295.12 / $524.81
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $436.52 / $630.96
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $870.96 / $870.96
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $933.25 / $933.25
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $398.11
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $147.91 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $794.33