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Maine 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
$274.83 / $368.48 / $1,166.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.00 / $222.61 / $412.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.95 / $404.00 / $1,896.17
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.93 / $109.93 / $239.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.21 / $586.21 / $586.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.19 / $278.24 / $290.39
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.83 / $274.83 / $277.58
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.83 / $274.83 / $1,228.49
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.61 / $274.83 / $274.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.16 / $164.90 / $412.25