go back

Montana rates for HCPCS 0067U

Oncology (breast), immunohistochemistry, protein expression profiling of 4 biomarkers (matrix metalloproteinase-1 [MMP-1], carcinoembryonic antigen-related cell adhesion molecule 6 [CEACAM6], hyaluronoglucosaminidase [HYAL1], highly expressed in cancer protein [HEC1]), formalin-fixed paraffin-embedded precancerous breast tissue, algorithm reported as carcinoma risk score

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,778.28 / $3,630.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $2,754.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $2,754.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,454.71 / $5,754.40
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,454.71 / $5,754.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,754.23 / $4,168.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,698.24 / $2,754.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $1,905.46