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Texas 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
$1,621.81 / $3,630.78 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,905.46 / $2,754.23
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $5,011.87 / $11,220.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $3,090.30 / $3,630.78
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,022.64 / $12,022.64 / $12,022.64
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,589.25 / $18,620.87 / $18,620.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,511.89 / $4,677.35
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,995.26 / $3,162.28
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,691.53 / $5,370.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,570.40 / $7,413.10
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,630.27 / $4,365.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,047.13 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,174.90 / $1,737.80
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $2,511.89 / $2,511.89