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West Virginia 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
$630.96 / $1,148.15 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $602.56 / $724.44
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $1,230.27 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $3,715.35 / $3,715.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $346.74 / $776.25