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Iowa 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 / $1,479.11 / $2,137.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $602.56 / $776.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,479.11 / $1,862.09
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $954.99 / $1,412.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $933.25 / $2,041.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $1,778.28
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $1,698.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $1,698.24
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $776.25 / $776.25