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Idaho rates for HCPCS 81460

Whole mitochondrial genome (eg, Leigh syndrome, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes [MELAS], myoclonic epilepsy with ragged-red fibers [MERFF], neuropathy, ataxia, and retinitis pigmentosa [NARP], Leber hereditary optic neuropathy [LHON]), genomic sequence, must include sequence analysis of entire mitochondrial genome with heteroplasmy detection

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,322.78 / $2,322.78 / $3,346.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.90 / $2,509.65 / $2,509.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,254.83 / $1,363.58 / $5,019.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$959.29 / $1,478.95 / $2,129.90
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,209.78 / $2,509.65 / $2,760.62
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,287.00 / $1,287.00 / $1,544.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984.56 / $1,287.00 / $2,509.65
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,930.50 / $2,574.00 / $4,633.20
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,093.95 / $2,263.54 / $2,263.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.54 / $540.54 / $1,544.40