go back

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
$316.05 / $316.05 / $316.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.50 / $398.50 / $398.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.50 / $398.50 / $398.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.50 / $398.50 / $398.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.35 / $247.35 / $398.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.43 / $115.43 / $274.83