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New Mexico 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
$3,801.89 / $8,317.64 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,041.74 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $5,370.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,162.28 / $7,413.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,754.23 / $2,754.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,513.56