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Maine rates for HCPCS 81504

Oncology (tissue of origin), microarray gene expression profiling of >2,000 genes, utilizing formalin-fixed paraffin-embedded tissue, algorithm reported as tissue similarity scores

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.00 / $520.00 / $1,300.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.20 / $421.20 / $520.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.20 / $631.64 / $1,797.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.96 / $208.00 / $338.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.42 / $526.37 / $549.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.00 / $520.00 / $525.20
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.00 / $520.00 / $1,300.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.20 / $520.00 / $520.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.20 / $312.00 / $910.00