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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
$912.01 / $1,698.24 / $2,089.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $645.65 / $954.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $2,041.74 / $2,089.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $3,019.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $1,023.29 / $1,949.84
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $794.33 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,454.71 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,148.15 / $2,344.23
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $1,513.56 / $4,570.88
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $4,570.88 / $5,011.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $724.44 / $2,630.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $478.63 / $2,754.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $64.57 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,778.28 / $2,511.89
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $3,630.78
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $3,801.89 / $3,801.89
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $602.56 / $1,621.81
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $2,754.23 / $4,168.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $602.56 / $912.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $478.63 / $1,318.26