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Utah 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
$1,150.00 / $1,150.00 / $4,257.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.64 / $795.60 / $1,150.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$800.05 / $822.85 / $2,579.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.93 / $1,075.86 / $1,712.81
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$936.00 / $1,076.40 / $3,790.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.07 / $1,009.79 / $1,121.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.12 / $393.12 / $561.60