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Maine rates for HCPCS 0103U

Hereditary ovarian cancer (eg, hereditary ovarian cancer, hereditary endometrial cancer), genomic sequence analysis panel utilizing a combination of NGS, Sanger, MLPA, and array CGH, with mRNA analytics to resolve variants of unknown significance when indicated (24 genes [sequencing and deletion/duplication], EPCAM [deletion/duplication only])

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $912.01 / $1,445.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $831.76 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $3,981.07 / $3,981.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $2,089.30
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $912.01 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $1,548.82 / $1,737.80