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Maryland 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
$2.43 / $655.68 / $1,056.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.00 / $206.12 / $386.20
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.83 / $302.31 / $390.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.66 / $195.50 / $793.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.83 / $329.80 / $412.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.43 / $131.19 / $240.25
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.41 / $137.41 / $137.41