go back

South 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
$1,737.80 / $6,165.95 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $1,995.26 / $2,754.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,691.53 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $6,309.57 / $14,454.40
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,137.96 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,511.89 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $2,511.89