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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
$251.19 / $954.99 / $1,348.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $218.78 / $912.01
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $562.34 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $269.15 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $229.09 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $177.83 / $1,230.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $302.00 / $549.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $1,380.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $275.42 / $331.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $165.96