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North Dakota 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
$537.03 / $537.03 / $1,380.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $933.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,548.82 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,122.02
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $912.01 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $398.11 / $1,318.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $776.25 / $1,122.02