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New Mexico 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
$3,801.89 / $8,317.64 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,041.74 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $3,890.45 / $5,370.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,162.28 / $7,413.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,754.23 / $3,630.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,174.90 / $1,513.56