CPT 81401: Tier 2, Level 2 Molecular Pathology Technical Test
Commercial payers pay $127 on average nationally for this procedure.
CPT code 81401 describes a Tier 2, Level 2 molecular pathology technical service in which a lab analyst performs the technical laboratory testing required to complete a specified genetic analysis; the service is classified as molecular diagnostic laboratory testing and is typically provided in a clinical laboratory or hospital laboratory setting.
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National Reimbursement Benchmarks
For CPT 81401, the BUCA average commercial benchmark is $126.70, providing a mid-market reference point among major national payers. Blue Cross Blue Shield (BCBS) and Cigna show higher central tendencies with medians of $128.10 and $136.70 respectively, while UnitedHealth Group’s median sits lower at $82.20 and Aetna’s median at $65.00, indicating dispersion in contracted commercial pricing around the BUCA average.
Examining interquartile dispersion (P75 minus P25) highlights concentration differences: Aetna has the tightest IQR at $70.50 (P75 $109.50 minus P25 $39.00), UnitedHealth Group follows with an IQR of $81.50, and BUCA’s IQR is $78.80. Cigna displays the widest IQR at $129.40, with Blue Cross Blue Shield also wide at $63.00. These comparisons show Cigna and BCBS exhibiting broader mid-distribution spread, while Aetna and UnitedHealth Group are relatively tighter around their medians.