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South Dakota rates for HCPCS 0288U

Oncology (lung), mRNA, quantitative PCR analysis of 11 genes (BAG1, BRCA1, CDC6, CDK2AP1, ERBB3, FUT3, IL11, LCK, RND3, SH3BGR, WNT3A) and 3 reference genes (ESD, TBP, YAP1), formalin-fixed paraffin-embedded (FFPE) tumor tissue, algorithmic interpretation reported as a recurrence risk score

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,640.62 / $3,640.62 / $3,640.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,594.91 / $3,020.94 / $3,640.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,563.11 / $7,034.57 / $8,793.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,655.34 / $4,385.39 / $7,110.05
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,975.23 / $2,323.80 / $7,622.06
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,647.60 / $5,034.89 / $8,488.01
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,647.60 / $6,777.75 / $8,488.01
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,538.39 / $9,331.21 / $10,639.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,626.66 / $1,975.23 / $3,873.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,873.00 / $3,873.00 / $3,873.00