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Tennessee 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
$204.17 / $229.09 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $218.78 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $275.42 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $575.44 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $177.83 / $380.19
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $1,318.26
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,041.74 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $275.42 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $165.96 / $275.42