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Michigan rates for HCPCS 81465

Whole mitochondrial genome large deletion analysis panel (eg, Kearns-Sayre syndrome, chronic progressive external ophthalmoplegia), including heteroplasmy detection, if performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$889.20 / $889.20 / $1,387.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.52 / $889.20 / $889.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.84 / $843.84 / $888.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$843.84 / $888.25 / $1,199.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.40 / $936.00 / $1,344.83
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$880.59 / $889.20 / $1,633.91
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$880.59 / $889.20 / $1,123.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.12 / $561.60 / $936.00