go back

Rhode Island 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
$2,238.72 / $3,467.37 / $3,467.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $537.03 / $630.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $1,659.59 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,096.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $1,122.02