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New Hampshire 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
$173.78 / $691.83 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $190.55 / $691.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $537.03 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $177.83 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $1,000.00 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $288.40 / $1,148.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $524.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $457.09