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Montana 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
$208.93 / $257.04 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $354.81 / $831.76
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $354.81 / $831.76
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $398.11 / $602.56
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $245.47 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $275.42