Molecular pathology test, tier level 4

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Pompe Known Mutation

Payers reporting CPT 81403

Payer pricing summary

Low

$145

Average

$468

Median

$350

High

$1.7k

Payer rate distribution

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Filter by billing class

#
1	UnitedHealthcare fee schedule · outpatient · +34 other terms	829	$186	$211	$141	67%	31–310	$1 – $2.6k
2	Caresource fee schedule · outpatient · +14 other terms	86	$188	$186	$49	26%	8–80	$1 – $1.2k
3	Humana fee schedule · outpatient · +25 other terms	543	$186	$319	$543	170%	6–60	$1 – $7.0k
4	Bcbs Al facility · other · outpatient · +3 other terms	5	$174	$182	$13	7%	6–60	$157 – $205
5	Anthem fee schedule · outpatient · +21 other terms	229	$224	$257	$260	101%	4–40	$5 – $1.9k
6	Aetna fee schedule · outpatient · +29 other terms	757	$211	$308	$332	108%	3–30	$0 – $8.4k
7	Cigna fee schedule · outpatient · +21 other terms	520	$345	$277	$191	69%	3–30	$4 – $1.9k
8	Optum fee schedule · outpatient · +20 other terms	75	$185	$256	$145	57%	3–30	$3 – $1.2k
9	Superior Healthplan fee schedule · outpatient · +6 other terms	63	$194	$388	$262	68%	3–30	$74 – $1.0k
10	Blue Cross Blue Shield fee schedule · outpatient · +31 other terms	534	$259	$399	$441	110%	—	$1 – $5.0k
11	WellCare fee schedule · outpatient · +19 other terms	310	$191	$184	$50	27%	—	$11 – $849
12	Molina fee schedule · outpatient · +29 other terms	288	$204	$244	$118	48%	—	$1 – $801
13	Devoted fee schedule · outpatient · +14 other terms	197	$185	$187	$5	3%	—	$182 – $214
14	Oscar fee schedule · outpatient · +17 other terms	165	$358	$377	$135	36%	—	$130 – $567
15	Cigna Healthspring fee schedule · outpatient · +8 other terms	142	$193	$191	$23	12%	—	$111 – $316
16	Kaiser fee schedule · outpatient · +19 other terms	126	$189	$219	$119	54%	—	$5 – $873
17	Ambetter fee schedule · outpatient · +16 other terms	115	$304	$247	$115	46%	—	$64 – $1.1k
18	MultiPlan fee schedule · outpatient · +18 other terms	109	$384	$482	$462	96%	—	$5 – $2.9k
19	Aetna Better Health fee schedule · outpatient · +19 other terms	74	$168	$176	$12	7%	—	$97 – $196
20	First Health fee schedule · outpatient · +16 other terms	72	$275	$477	$434	91%	—	$5 – $1.8k
21	Highmark facility · fee schedule · outpatient · +16 other terms	63	$333	$852	$637	75%	—	$167 – $2.3k
22	Medicaid facility · fee schedule · outpatient · +12 other terms	58	$165	$168	$29	17%	—	$99 – $254
23	Tricare fee schedule · outpatient · +16 other terms	55	$185	$468	$611	131%	—	$5 – $2.6k
24	Medicare facility · fee schedule · outpatient · +12 other terms	53	$182	$180	$33	18%	—	$5 – $326
25	Clover facility · fee schedule · outpatient · +8 other terms	49	$189	$188	$4	2%	—	$182 – $198

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