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North Carolina 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
$616.60 / $2,454.71 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $616.60 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,621.81 / $2,454.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $691.83 / $691.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $1,230.27 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $933.25 / $1,174.90
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $616.60 / $776.25
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $575.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $776.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $389.05 / $776.25
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $3,630.78