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Louisiana 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
$288.40 / $398.11 / $1,318.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $234.42 / $416.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $537.03 / $870.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $302.00 / $302.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $691.83 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $281.84 / $537.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $138.04 / $389.05