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South Dakota 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
$257.04 / $257.04 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $208.93 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $524.81 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $524.81 / $660.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $309.03 / $501.19
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.25 / $165.96 / $1,380.38
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $331.13
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $645.65 / $758.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $165.96 / $316.23
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42