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Louisiana 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
$812.83 / $1,122.02 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $630.96 / $933.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $1,513.56 / $2,398.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.70 / $38.02 / $38.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $870.96 / $5,888.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,096.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $691.83 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $389.05 / $851.14