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Maryland 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
Professional
Modifier
Low / Median / High Price
$1,631.64 / $1,882.66 / $1,882.66
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,008.17 / $2,259.19 / $2,575.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,478.23 / $1,478.23 / $1,478.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,510.21 / $3,012.25 / $3,765.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.29 / $1,255.10 / $2,284.23
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.10 / $1,255.10 / $1,255.10