go back

Oklahoma 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
$1,862.09 / $2,511.89 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,949.84 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $6,760.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,630.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,511.89 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,174.90 / $9,332.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $2,511.89 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,174.90 / $1,659.59