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Pennsylvania 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)

Facilitymedian $6,166 · 10th–90th $1,995–$10,7150%10%10th90th$6,166Professionalmedian $1,995 · 10th–90th $1,380–$4,4670%10%20%10th90th$1,995$200.0$1.0K$5.0K$20.0K

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
$1,995.26 / $6,309.57 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,995.26 / $7,244.36
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $11,481.54 / $16,595.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,981.07 / $8,317.64
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,089.30 / $3,630.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,187.76 / $3,311.31
Geisinger
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,951.21 / $4,570.88
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $4,897.79 / $9,549.93
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,454.71
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $4,677.35 / $8,709.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,995.26 / $2,951.21
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $2,041.74 / $2,691.53
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $2,041.74 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,454.71 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,479.11 / $3,235.94