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Missouri 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
$442.00 / $699.05 / $1,206.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.20 / $452.40 / $598.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$520.00 / $546.00 / $2,400.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.28 / $426.02 / $927.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$716.22 / $1,004.20 / $1,239.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.82 / $495.20 / $673.20
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$442.00 / $650.00 / $2,470.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.40 / $312.00 / $2,600.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.40 / $312.00 / $624.00