CPT 81402: Molecular Pathology Tier 2 Level 3 Technical Test
Commercial payers pay $222 on average nationally for this procedure.
CPT code 81402 describes a molecular pathology Tier 2, Level 3 technical laboratory service in which the lab analyst performs the technical component of a specific genetic analysis; the service type is molecular diagnostic technical test and the typical site of service is a clinical molecular laboratory or hospital laboratory where sequencing, amplification, or other molecular techniques are conducted to generate analyzable genetic data.
For related coverage guidance, see recent payer policy updates: Oral Cancer Screening and Testing, RTM Testing for Alpha-1 Antitrypsin Deficiency, Cytochrome P450 Genotype-Guided Treatment Strategy Corporate Medical Policy.
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National Reimbursement Benchmarks
National commercial reimbursement centers on BUCA’s average commercial rate of $222.50 for CPT 81402, with individual payers showing notable spread around that midpoint. Blue Cross Blue Shield displays the widest middle spread (P75–P25 = $125.10), reflecting greater variability in negotiated commercial rates, while Aetna’s middle 50% is much tighter (P75–P25 = $11.20), indicating more clustered pricing. Cigna and UnitedHealth Group show moderate dispersion (Cigna P75–P25 = $121.75; UnitedHealth Group P75–P25 = $87.70), and BUCA’s IQR (P75–P25 = $106.30) sits between those extremes.
Mean rates also vary: Blue Cross Blue Shield and BUCA have higher averages ($290.80 and $222.50 respectively), while Aetna and UnitedHealth Group have lower means ($87.20 and $119.90 respectively), with Cigna in the middle at $187.10. This mix of mean levels and interquartile spreads highlights that some payers price more consistently at lower levels and others show both higher averages and greater variability in commercial reimbursement for this code.