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Nebraska 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
$1,778.28 / $6,606.93 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,905.46 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,513.56 / $2,951.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,630.78 / $3,890.45 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $4,786.30 / $6,025.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $1,659.59 / $12,022.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $8,128.31
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $2,398.83 / $5,011.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,513.56 / $2,511.89