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Montana 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
Professional
Modifier
Low / Median / High Price
$1,076.40 / $6,018.48 / $6,018.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,357.20 / $1,825.20 / $2,765.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,075.86 / $1,357.20 / $1,357.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,357.20 / $1,825.20 / $2,765.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$842.40 / $842.40 / $1,357.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.12 / $393.12 / $936.00