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Arizona rates for HCPCS 0095U

Eosinophilic esophagitis, 2 protein biomarkers (Eotaxin-3 [CCL26 {C-C motif chemokine ligand 26}] and Major Basic Protein [PRG2 {proteoglycan 2, pro eosinophil major basic protein}]), enzyme-linked immunosorbent assays (ELISA), specimen obtained by esophageal string test device, algorithm reported as probability of active or inactive eosinophilic esophagitis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$703.43 / $1,137.90 / $3,080.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578.99 / $578.99 / $3,080.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$431.85 / $1,698.78 / $2,825.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.13 / $650.38 / $926.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$507.39 / $1,204.30 / $2,157.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.12 / $940.81 / $1,176.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.18 / $633.02 / $3,666.91
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.23 / $324.23 / $617.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.23 / $324.23 / $617.58