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Alaska rates for HCPCS 0120U

Oncology (B-cell lymphoma classification), mRNA, gene expression profiling by fluorescent probe hybridization of 58 genes (45 content and 13 housekeeping genes), formalin-fixed paraffin-embedded tissue, algorithm reported as likelihood for primary mediastinal B-cell lymphoma (PMBCL) and diffuse large B-cell lymphoma (DLBCL) with cell of origin subtyping in the latter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,427.40 / $17,323.00 / $29,432.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,409.20 / $8,409.20 / $8,409.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,934.47 / $6,934.47 / $6,934.47
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,025.16 / $12,025.16 / $12,025.16
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,510.21 / $2,510.21 / $8,082.88
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,785.74 / $9,287.78 / $10,040.84
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,259.19 / $5,647.97 / $5,647.97
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,934.47 / $9,287.78 / $12,025.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,670.08 / $7,670.08 / $7,670.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,789.12 / $5,578.24 / $7,573.83