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Hawaii 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
$630.96 / $758.58 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $602.56 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $912.01 / $954.99
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $933.25 / $1,148.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $776.25 / $1,148.15