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Arizona rates for HCPCS 0295U

Oncology (breast ductal carcinoma in situ), protein expression profiling by immunohistochemistry of 7 proteins (COX2, FOXA1, HER2, Ki-67, p16, PR, SIAH2), with 4 clinicopathologic factors (size, age, margin status, palpability), utilizing formalin-fixed paraffin-embedded (FFPE) tissue, algorithm reported as a recurrence risk score

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,412.54 / $3,630.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,235.94 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $5,495.41 / $10,232.93
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $26,915.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $794.33 / $2,290.87