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Washington, DC 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
$578.99 / $578.99 / $4,724.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578.99 / $578.99 / $578.99
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$617.58 / $617.58 / $617.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,254.48 / $1,304.65 / $2,806.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.12 / $887.12 / $1,108.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,569.20 / $1,569.20 / $1,569.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.23 / $347.39 / $702.49