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Ohio rates for HCPCS 81416

Exome (eg, unexplained constitutional or heritable disorder or syndrome); sequence analysis, each comparator exome (eg, parents, siblings) (List separately in addition to code for primary procedure)

Facilitymedian $10,965 · 10th–90th $2,042–$28,8400%5%10%10th90th$10,965Professionalmedian $9,120 · 10th–90th $1,000–$14,4540%20%10th90th$9,120$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $12,882.50 / $30,199.52
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $9,549.93 / $14,454.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,365.16 / $5,011.87 / $8,709.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $5,754.40 / $12,589.25
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $9,120.11 / $13,803.84
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16,218.10 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,762.47 / $14,791.08 / $48,977.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $7,762.47 / $22,908.68
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $7,762.47 / $40,738.03
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $6,309.57 / $23,988.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,912.51 / $10,715.19 / $14,791.08
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$14,454.40 / $14,454.40 / $14,454.40
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,912.51 / $12,589.25 / $24,547.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $12,022.64 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,244.36 / $13,803.84