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Indiana 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
$2,884.03 / $3,890.45 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,041.74 / $2,398.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $302.00 / $645.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $36,307.81 / $54,954.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $9,772.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $2,754.23 / $7,585.78
United
Facility/Professional
Facility
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 / $1,513.56 / $2,511.89