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Hawaii 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
$2,070.92 / $2,347.05 / $3,012.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,330.41 / $1,330.41 / $1,330.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,012.25 / $3,012.25 / $3,012.25
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,628.49 / $3,151.71 / $3,486.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,761.23 / $3,012.25 / $3,514.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,789.12 / $3,012.25 / $3,765.32