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New Hampshire 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
$1,441.44 / $3,167.31 / $9,009.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,003.86 / $1,580.00 / $1,580.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.12 / $2,491.37 / $5,817.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.79 / $836.55 / $944.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,380.82 / $5,277.52 / $5,555.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.68 / $1,478.95 / $5,347.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,287.00 / $1,867.95 / $4,239.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$514.79 / $772.20 / $772.20
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.91 / $1,046.00 / $1,331.27