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Hawaii rates for HCPCS 0017M

Oncology (diffuse large B-cell lymphoma [DLBCL]), mRNA, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of origin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,511.89 / $3,019.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,137.96 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,630.27 / $3,162.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $3,019.95 / $3,801.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $2,511.89 / $3,801.89