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Missouri 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
$2,454.71 / $4,265.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,137.96 / $2,691.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $1,513.56 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $4,897.79 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $3,019.95 / $12,022.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $12,589.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $2,511.89 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $2,818.38