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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
$1,281.49 / $1,281.49 / $1,692.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.39 / $540.39 / $609.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.59 / $1,432.95 / $2,026.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$887.12 / $887.12 / $1,108.91
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.18 / $617.58 / $771.98
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.79 / $771.98 / $771.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.23 / $385.99 / $771.98
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,343.25 / $3,666.91 / $3,666.91