go back

Illinois 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
$1,106.82 / $2,380.94 / $3,011.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$990.99 / $1,055.33 / $1,635.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.45 / $5,539.63 / $17,025.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.50 / $888.03 / $990.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.35 / $3,197.45 / $5,925.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$628.05 / $1,493.74 / $2,172.51
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,287.00 / $1,930.50 / $2,890.51
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,673.10 / $1,673.10 / $1,673.10
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.50 / $1,287.00 / $1,891.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.54 / $772.20 / $1,287.00