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Arizona 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
$250.43 / $436.43 / $1,096.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.00 / $184.14 / $1,767.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.41 / $719.31 / $1,139.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.33 / $262.30 / $1,270.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.94 / $482.33 / $803.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.12 / $206.57 / $274.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$184.14 / $281.25 / $496.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.43 / $115.43 / $1,374.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.43 / $115.43 / $164.90