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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
$1,737.80 / $2,041.74 / $2,630.27
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,995.26 / $2,290.87
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,884.03 / $3,801.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,905.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,122.02 / $2,041.74
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,258.93