CPT 81406: Molecular Pathology Tier 2, Level 7 Technical Component
Commercial payers pay $295 on average nationally for this procedure.
CPT code 81406 describes a molecular pathology Tier 2, Level 7 procedure where a laboratory analyst performs the technical component of a specific genetic analysis to generate raw molecular data; service type is molecular pathology testing (technical component) and the typical site of service is a clinical laboratory or pathology lab performing specialized genetic testing.
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National Reimbursement Benchmarks
National commercial reimbursement for CPT 81406 centers on a BUCA average commercial rate of $295.00, with substantial variation among major payers. Blue Cross Blue Shield (BCBS) and Cigna show higher central tendency figures—BCBS median $294.70 and Cigna median $294.80—while Aetna and UnitedHealth Group sit lower at medians of $99.70 and $169.70, respectively. This positions BUCA’s mean near the upper-mid range of payer medians, indicating that average commercial contracts tend to cluster above Aetna’s typical levels but below Cigna’s occasional high outliers.
Rate dispersion (P75 minus P25) highlights where contractual spreads are tightest and widest: UnitedHealth Group has the tightest interquartile spread at $165.10 ($282.90 - $118.80), followed by Aetna at $160.00 ($226.00 - $59.00). The widest spreads occur with Cigna at $282.00 ($435.30 - $152.30) and BCBS at $145.20 ($353.60 - $207.40) when compared by absolute IQRs, reflecting greater variability in commercial pricing for those payers relative to others.