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Montana rates for HCPCS 81412

Ashkenazi Jewish associated disorders (eg, Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, Tay-Sachs disease), genomic sequence analysis panel, must include sequencing of at least 9 genes, including ASPA, BLM, CFTR, FANCC, GBA, HEXA, IKBKAP, MCOLN1, and SMPD1

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.00 / $2,815.84 / $15,744.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,281.07 / $3,281.07 / $3,281.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,550.41 / $4,774.68 / $7,235.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,813.77 / $3,550.41 / $3,550.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,550.41 / $4,774.68 / $7,235.49
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,203.69 / $2,203.69 / $3,550.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.88 / $1,028.40 / $2,448.56