go back

Wisconsin 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
Facility
Modifier
Low / Median / High Price
$5,248.07 / $5,248.07 / $5,248.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $1,819.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $6,606.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $6,165.95 / $9,772.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $4,786.30 / $5,888.44
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $7,943.28 / $12,022.64
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,481.54 / $11,481.54 / $12,589.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $2,290.87 / $6,606.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,148.15 / $9,549.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $85.11
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $4,466.84 / $6,309.57
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $8,912.51 / $8,912.51
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $7,585.78 / $9,549.93
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $4,073.80
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $10,471.29 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,513.56 / $2,290.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,148.15 / $3,162.28