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Montana rates for HCPCS 81443

Genetic testing for severe inherited conditions (eg, cystic fibrosis, Ashkenazi Jewish-associated disorders [eg, Bloom syndrome, Canavan disease, Fanconi anemia type C, mucolipidosis type VI, Gaucher disease, Tay-Sachs disease], beta hemoglobinopathies, phenylketonuria, galactosemia), genomic sequence analysis panel, must include sequencing of at least 15 genes (eg, ACADM, ARSA, ASPA, ATP7B, BCKDHA, BCKDHB, BLM, CFTR, DHCR7, FANCC, G6PC, GAA, GALT, GBA, GBE1, HBB, HEXA, IKBKAP, MCOLN1, PAH)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,081.28 / $2,289.40 / $15,744.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,281.07 / $8,530.78 / $94,999.99
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 / $4,162.55 / $13,956.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,155.76 / $3,550.41 / $3,550.41
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,550.41 / $4,162.55 / $13,956.79
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
$1,028.40 / $1,028.40 / $2,448.56