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Maryland rates for HCPCS 0155U

Oncology (breast cancer), DNA, PIK3CA (phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit alpha) (eg, breast cancer) gene analysis (ie, p.C420R, p.E542K, p.E545A, p.E545D [g.1635G>T only], p.E545G, p.E545K, p.Q546E, p.Q546R, p.H1047L, p.H1047R, p.H1047Y), utilizing formalin-fixed paraffin-embedded breast tumor tissue, reported as PIK3CA gene mutation status

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $223.87 / $288.40
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $218.78 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $144.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $316.23 / $416.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.82 / $114.82 / $208.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $123.03 / $223.87
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $218.78 / $218.78