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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
$307.81 / $676.36 / $1,923.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.38 / $192.38 / $222.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.10 / $502.39 / $1,071.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.93 / $178.63 / $178.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.26 / $1,004.31 / $1,205.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.83 / $398.89 / $905.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.43 / $164.90 / $274.83
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00