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Texas 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
$165.96 / $512.86 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $223.87 / $398.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $131.83 / $165.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $891.25 / $1,659.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.01 / $151.36 / $371.54
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $234.42 / $245.47
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $562.34 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $263.03 / $512.86
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
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.53 / $275.42 / $630.96
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $218.78 / $354.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $229.09 / $263.03
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $295.12 / $588.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $316.23 / $812.83
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $281.84 / $467.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $114.82 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $190.55
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $229.09 / $275.42