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South Dakota rates for HCPCS 0154U

Oncology (urothelial cancer), RNA, analysis by real-time RT-PCR of the FGFR3 (fibroblast growth factor receptor 3) gene analysis (ie, p.R248C [c.742C>T], p.S249C [c.746C>G], p.G370C [c.1108G>T], p.Y373C [c.1118A>G], FGFR3-TACC3v1, and FGFR3-TACC3v3) utilizing formalin-fixed paraffin-embedded urothelial cancer tumor tissue, reported as FGFR gene alteration status

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $549.54 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $363.08 / $549.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $933.25 / $1,148.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $549.54 / $891.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $123.03 / $2,398.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,122.02 / $1,318.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $123.03 / $478.63
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $478.63 / $478.63