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Pennsylvania 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 $30,200 · 10th–90th $8,710–$51,2860%10%10th90th$30,200Professionalmedian $9,550 · 10th–90th $1,000–$21,8780%20%10th90th$9,550$1.0K$2.0K$5.0K$10.0K$20.0K$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
$8,709.64 / $30,902.95 / $50,118.72
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $9,549.93 / $23,442.29
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22,387.21 / $56,234.13 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,332.54 / $9,332.54 / $9,332.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,943.28 / $18,197.01 / $35,481.34
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,309.57 / $13,489.63 / $26,915.35
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $10,715.19 / $17,378.01
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,912.51 / $13,803.84 / $22,908.68
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,311.31 / $12,589.25
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12,022.64 / $12,022.64 / $12,022.64
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $16,982.44 / $40,738.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $9,549.93 / $14,454.40
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,022.64 / $13,182.57 / $13,182.57
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10,471.29 / $12,302.69 / $13,182.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $12,022.64 / $14,454.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,244.36 / $15,848.93