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Indiana 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
$2,511.89 / $3,890.45 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,041.74 / $2,398.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,513.56 / $2,630.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $36,307.81 / $54,954.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $3,090.30 / $7,585.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $2,754.23