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Utah rates for HCPCS 0108U

Gastroenterology (Barrett's esophagus), whole slide-digital imaging, including morphometric analysis, computer-assisted quantitative immunolabeling of 9 protein biomarkers (p16, AMACR, p53, CD68, COX-2, CD45RO, HIF1a, HER-2, K20) and morphology, formalin-fixed paraffin-embedded tissue, algorithm reported as risk of progression to high-grade dysplasia or cancer

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,238.72 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,888.44 / $5,888.44 / $5,888.44
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $79.43
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,454.71 / $4,168.69
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,467.37 / $3,467.37 / $4,897.79
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $4,365.16 / $5,495.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,513.56 / $2,951.21