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Pennsylvania rates for HCPCS 0017M

Oncology (diffuse large B-cell lymphoma [DLBCL]), mRNA, gene expression profiling by fluorescent probe hybridization of 20 genes, formalin-fixed paraffin-embedded tissue, algorithm reported as cell of origin

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $6,456.54 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,041.74 / $2,884.03
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,467.37 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,022.64 / $12,022.64 / $12,022.64
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $3,388.44 / $5,495.41
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,884.03 / $4,786.30
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $6,456.54 / $10,964.78
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,041.74 / $7,413.10
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $3,715.35 / $3,981.07
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,754.23 / $4,265.80
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,754.23 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $3,388.44