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Wisconsin rates for HCPCS 81422

Fetal chromosomal microdeletion(s) genomic sequence analysis (eg, DiGeorge syndrome, Cri-du-chat syndrome), circulating cell-free fetal DNA in maternal blood

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$910.86 / $1,138.57 / $1,692.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.43 / $713.51 / $910.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,631.96 / $1,973.53 / $2,087.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.62 / $523.74 / $3,251.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$759.05 / $910.86 / $1,927.99
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.05 / $759.05 / $981.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.80 / $2,440.92 / $3,744.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$872.26 / $1,915.46 / $2,322.69
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.43 / $683.15 / $1,492.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.43 / $713.51 / $3,605.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.17 / $607.24 / $2,102.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.00 / $85.00 / $759.05
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.43 / $683.15 / $1,492.32
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,267.38 / $1,810.24 / $2,538.98
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,518.10 / $1,518.10 / $3,605.49
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.74 / $3,795.25 / $3,795.25
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.75 / $601.75 / $1,616.43
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.75 / $683.15 / $4,144.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.24 / $607.24 / $1,647.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$401.17 / $607.24 / $1,421.62