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Mitochondrial DNA Large Deletion Test

South Dakota rates for HCPCS 81465

A laboratory test that examines the DNA inside mitochondria, the structures that generate energy inside cells, looking for large missing sections. It also reports what proportion of a person's mitochondria carry the change, since this varies from cell to cell and from tissue to tissue.

Rates data updated July 2026.

Facilitymedian $1,778 · 10th–90th $891$1,7780%50%10th$1,778Professionalmedian $1,122 · 10th–90th $631$2,2390%10%20%10th90th$1,122$0.0$0.2$2.0$20.0$200.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$660.69
Median
$1,071.52
Typical High
$1,071.52
Aetna
Setting
Professional
Modifier
Global
Typical Low
$630.96
Median
$724.44
Typical High
$870.96
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1,778.28
Median
$1,778.28
Typical High
$1,778.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,318.26
Median
$1,778.28
Typical High
$2,238.72
Medica
Setting
Facility
Modifier
Global
Typical Low
$0.02
Median
$1,071.52
Typical High
$4,466.84
Medica
Setting
Professional
Modifier
Global
Typical Low
$478.63
Median
$478.63
Typical High
$4,677.35
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1,348.96
Median
$2,187.76
Typical High
$2,570.40
United
Setting
Facility
Modifier
Global
Typical Low
$1,122.02
Median
$1,122.02
Typical High
$1,122.02
United
Setting
Professional
Modifier
Global
Typical Low
$389.05
Median
$562.34
Typical High
$1,230.27
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$933.25
Median
$933.25
Typical High
$933.25