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Indiana 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
$225.36 / $274.83 / $961.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.00 / $225.36 / $386.20
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.12 / $245.97 / $824.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.93 / $109.93 / $223.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.83 / $329.80 / $384.76
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.83 / $302.31 / $389.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.64 / $274.83 / $639.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.11 / $247.46 / $399.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.43 / $164.90 / $302.04