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New Hampshire 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
Facility
Modifier
Low / Median / High Price
$691.83 / $691.83 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $204.17 / $239.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $524.81 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $177.83 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $870.96 / $1,202.26
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $524.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $165.96 / $288.40