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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
$1,261.51 / $1,612.45 / $1,612.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,930.34 / $3,088.54 / $3,474.60
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,641.45 / $5,435.00 / $10,346.77
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.74 / $796.74 / $27,066.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.74 / $796.74 / $2,282.69