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Utah 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
$245.47 / $1,318.26 / $1,737.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $245.47 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $239.88 / $758.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $331.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $44.67 / $79.43
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $331.13 / $1,288.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $245.47 / $275.42
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $190.55 / $794.33
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $239.88 / $416.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $114.82 / $165.96