CPT 81451: Targeted RNA Sequence Panel for Hematolymphoid Disorders
Commercial payers pay $711 on average nationally for this procedure.
CPT code 81451 describes a targeted genomic sequence analysis panel in which a laboratory analyst evaluates a patient specimen for RNA alterations across 5 to 50 genes associated with hematolymphoid (blood or lymph) cancers or disorders, typically performed as a molecular diagnostic genomic test on blood or bone marrow specimens in a clinical laboratory or hospital molecular pathology setting.
For related coverage guidance, see recent payer policy updates: RTM Testing of Homocysteine Metabolism-Related Conditions, Multimarker Serum Testing Related to Ovarian Cancer, Genomic Profiling for Selecting Targeted Cancer Therapies.
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National Reimbursement Benchmarks
Commercial reimbursement for CPT 81451 clusters around BUCA’s average commercial rate of $711.40, with individual payers showing meaningful spread. Blue Cross Blue Shield peaks with a high mean and sizable upper tail, while Aetna and UnitedHealth Group sit lower on median values. Cigna’s mean and max suggest higher-cost outliers are present. Overall, the landscape is heterogeneous: some payers center near BUCA’s average while others extend substantially above it, indicating variable negotiated prices across commercial contracts.
Dispersion measured by the interquartile range (P75–P25) highlights which payers are tightest and widest. Aetna’s IQR is $135.00 ($630.00–$379.50), the tightest range, suggesting more concentrated pricing. Blue Cross Blue Shield’s IQR is $306.40 ($939.70–$563.30) and Cigna’s IQR is $521.90 ($917.40–$397.50), the widest, indicating broader variability; UnitedHealth Group’s IQR is $369.50 ($759.50–$319.00). BUCA’s quartiles span $210.00 ($854.30–$464.30).