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Kentucky 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
$633.02 / $771.98 / $3,433.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$609.86 / $771.98 / $771.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.79 / $308.79 / $566.63
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$771.98 / $1,235.17 / $41,999.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$849.18 / $1,080.77 / $14,321.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.79 / $589.10 / $926.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$868.32 / $1,108.91 / $3,720.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.23 / $463.19 / $849.18