CPT 81420: Cell-Free Fetal DNA Panel for Chromosomes 13, 18, 21
Commercial payers pay $766 on average nationally for this procedure.
CPT code 81420 describes a genomic sequence analysis panel performed on maternal plasma to evaluate circulating cell-free fetal DNA for genetic sequences on chromosomes 13, 18, and 21 to assess fetal chromosomal aneuploidy; this is a noninvasive prenatal screening service typically performed in a laboratory setting using maternal blood specimens and ordered as part of prenatal screening.
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National Reimbursement Benchmarks
For CPT 81420 the national commercial landscape centers on a BUCA average of $766.40, with individual commercial payers showing meaningful dispersion in middle-to-upper percentiles. Blue Cross Blue Shield (BCBS) and Cigna exhibit higher median and upper-percentile concentrations, while Aetna and UnitedHealth Group sit lower on median values. BUCA’s quartiles ($524.80 to $847.70) place it near the upper-middle of the payer set, signaling that the average commercial environment for this code is elevated relative to some large national payers.
Examining interquartile dispersion (P75 minus P25) highlights variation in pricing consistency: Blue Cross Blue Shield’s IQR is $228.80, Cigna’s is $595.40, BUCA’s is $322.90, Aetna’s is $299.40, and UnitedHealth Group’s is $370.30. Cigna therefore shows the widest IQR at $595.40, indicating the greatest middle-range variability, while Blue Cross Blue Shield has the tightest IQR at $228.80, indicating comparatively concentrated commercial rates.