go back

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
$291.32 / $378.72 / $1,429.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.90 / $332.54 / $412.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$297.58 / $536.72 / $859.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.35 / $302.31 / $302.31
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.83 / $274.83 / $274.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.52 / $685.42 / $1,277.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.80 / $284.83 / $565.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.43 / $156.68 / $398.50