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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
$588.84 / $1,548.82 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $575.44 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $1,412.54 / $2,089.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $645.65 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $602.56 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $933.25 / $1,174.90
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $630.96 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $776.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $776.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $616.60