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Tennessee 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
$151.36 / $616.60 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $575.44 / $851.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $776.25 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,584.89 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $933.25 / $1,174.90
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $3,630.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $524.81 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $776.25