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Vermont 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
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,258.93 / $1,584.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,479.11 / $2,884.03
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $1,288.25 / $2,951.21