go back

Louisiana 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
$2,660.82 / $3,622.23 / $13,203.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,506.13 / $2,987.15 / $3,263.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,931.92 / $5,084.93 / $8,452.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.35 / $1,553.24 / $1,654.57
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,510.21 / $2,510.21 / $2,510.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,626.81 / $4,815.59 / $17,730.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.29 / $1,506.13 / $3,625.86