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North Dakota 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
$1,757.15 / $1,757.15 / $4,518.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,757.15 / $2,359.60 / $2,359.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,778.50 / $5,058.07 / $5,647.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,619.00 / $2,619.00 / $3,273.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,506.13 / $1,907.76 / $4,518.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.21 / $3,012.25 / $5,020.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.29 / $2,560.41 / $3,639.80