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Pennsylvania 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
$234.42 / $691.83 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $223.87 / $912.01
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,318.26 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $213.80 / $446.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $446.68 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $295.12 / $616.60
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $363.08 / $524.81
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $346.74 / $602.56
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $549.54 / $1,621.81
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $691.83 / $1,148.15
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $257.04 / $954.99
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $389.05
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $229.09 / $302.00
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $275.42 / $407.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $331.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $165.96 / $346.74