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Connecticut 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
$776.25 / $776.25 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $512.86 / $741.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,288.25 / $2,089.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $467.74 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $2,570.40 / $3,890.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,096.48
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $457.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $575.44 / $1,348.96