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Wyoming 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
$1,287.00 / $1,287.00 / $1,287.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,287.00 / $1,287.00 / $1,287.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,608.75 / $1,995.00 / $4,118.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,573.71 / $2,573.71 / $2,573.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,478.95 / $1,848.69 / $2,766.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.54 / $540.54 / $1,287.00