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West Virginia 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
$2,041.74 / $3,801.89 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,041.74 / $2,344.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $3,388.44 / $3,388.44
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $3,981.07 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,022.64 / $12,022.64 / $12,022.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,122.02 / $3,162.28