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Alaska rates for HCPCS 81404

Molecular pathology procedure, Level 5 (eg, analysis of 2-5 exons by DNA sequence analysis, mutation scanning or duplication/deletion variants of 6-10 exons, or characterization of a dynamic mutation disorder/triplet repeat by Southern blot analysis)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $3,388.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $263.03 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $1,318.26
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $275.42 / $891.25
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $1,023.29 / $1,096.48
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $616.60 / $616.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $758.58 / $1,318.26
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $245.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $549.54 / $831.76