go back

North Dakota 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
$1,737.80 / $2,344.23 / $4,466.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,905.46 / $2,344.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.31 / $4,786.30 / $5,623.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $3,630.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,905.46 / $4,466.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $3,235.94 / $5,011.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $2,754.23 / $4,265.80