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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
$1,757.15 / $1,757.15 / $4,518.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,757.15 / $2,359.60 / $2,359.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,778.50 / $5,058.07 / $5,647.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.39 / $2,884.39 / $4,234.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,506.13 / $1,907.76 / $4,518.38
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,422.45 / $3,312.22 / $5,020.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.29 / $3,213.07 / $4,822.10