go back

Missouri 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
$741.31 / $1,288.25 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $660.69 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $562.34 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,479.11 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,096.48
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,348.96 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $776.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $912.01