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Texas 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
$343.20 / $911.04 / $2,553.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.20 / $384.80 / $624.00
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.00 / $520.00 / $520.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.11 / $1,220.42 / $2,757.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.56 / $494.16 / $818.88
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $2,470.00 / $2,470.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,600.00 / $2,600.00 / $3,900.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$317.20 / $520.00 / $780.00
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.00 / $520.00 / $650.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.00 / $624.00 / $1,170.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.22 / $520.00 / $1,571.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.23 / $598.00 / $818.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.40 / $218.40 / $520.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.00 / $208.00 / $520.00