go back

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
$269.15 / $380.19 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $223.87 / $489.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $831.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $109.65 / $223.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $331.13 / $371.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $302.00 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $275.42 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $251.19 / $524.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $165.96 / $275.42