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North Carolina 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
$1,995.26 / $1,995.26 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,995.26 / $2,454.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $5,623.41 / $7,943.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,511.89 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $3,981.07 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $2,238.72 / $3,467.37
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $3,235.94 / $4,786.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $2,951.21 / $3,090.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $2,754.23
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $12,022.64 / $12,022.64
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $18,620.87