go back

Idaho 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
$4,570.88 / $4,570.88 / $6,456.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,041.74 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $4,677.35 / $9,120.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,570.40 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $5,248.07 / $9,772.37
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $4,897.79
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,630.27 / $3,019.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $77.62
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $4,677.35 / $9,120.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,630.27
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $2,511.89