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Montana 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

Facilitymedian $955 · 10th–90th $776–$2,3440%20%10th90th$955Professionalmedian $724 · 10th–90th $537–$9550%20%10th90th$724$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $724.44 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,096.48 / $1,122.02
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $954.99 / $2,344.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $954.99 / $2,344.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $691.83 / $954.99
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $933.25 / $933.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $776.25