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Tennessee 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
$965.25 / $1,785.71 / $4,607.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$855.86 / $1,003.86 / $1,145.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.24 / $1,287.00 / $2,445.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$836.55 / $2,772.97 / $4,035.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.77 / $759.40 / $2,192.17
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,239.38 / $6,113.25 / $6,113.25
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,435.00 / $6,435.00 / $9,652.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.54 / $772.20 / $1,287.00