go back

Missouri 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
$2,454.71 / $4,265.80 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,137.96 / $2,691.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $8,709.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,548.82 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $5,248.07 / $6,025.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $2,884.03
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $3,019.95 / $12,022.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,659.59 / $12,589.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $2,511.89 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $3,019.95