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New York 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)

Facilitymedian $525 · 10th–90th $275$8320%20%10th90th$525Professionalmedian $224 · 10th–90th $110$5370%10%20%10th90th$224$10.0$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $524.81 / $831.76
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $234.42 / $645.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $707.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $416.87
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $275.42 / $275.42
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $588.84 / $1,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $371.54 / $1,318.26
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $588.84 / $1,023.29
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $245.47 / $524.81
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $489.78
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $912.01
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $512.86 / $50,118.72
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $275.42 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $229.09 / $616.60
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$234.42 / $288.40 / $288.40
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $263.03 / $660.69