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Louisiana rates for HCPCS 0120U

Oncology (B-cell lymphoma classification), mRNA, gene expression profiling by fluorescent probe hybridization of 58 genes (45 content and 13 housekeeping genes), formalin-fixed paraffin-embedded tissue, algorithm reported as likelihood for primary mediastinal B-cell lymphoma (PMBCL) and diffuse large B-cell lymphoma (DLBCL) with cell of origin subtyping in the latter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $3,630.78 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,187.76 / $3,162.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $5,128.61 / $8,511.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $1,548.82
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $4,786.30 / $19,054.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $2,511.89 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,380.38 / $3,890.45