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Maryland 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
Professional
Modifier
Low / Median / High Price
$1,631.64 / $1,882.66 / $1,882.66
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,008.17 / $2,334.50 / $2,661.33
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,510.21 / $2,886.74 / $3,765.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.29 / $1,129.58 / $2,284.23
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.10 / $1,255.10 / $1,255.10