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Georgia 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
$512.86 / $691.83 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $602.56 / $741.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $912.01 / $1,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $776.25 / $776.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $537.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,698.24 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $933.25 / $1,174.90
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $891.25 / $1,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $691.83 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $1,122.02