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Vermont 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
Professional
Modifier
Low / Median / High Price
$175.00 / $175.00 / $1,767.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$761.24 / $761.24 / $776.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$460.00 / $460.00 / $815.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$617.88 / $617.88 / $617.88
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$460.00 / $460.00 / $815.74
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.64 / $178.64 / $617.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.05 / $274.83 / $1,236.74