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California 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
$1,233.05 / $1,574.51 / $1,783.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,549.20 / $1,781.58 / $2,819.54
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,472.92 / $3,532.75 / $7,871.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,978.44 / $12,978.44 / $12,978.44
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,435.00 / $5,978.50 / $8,696.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,891.50 / $5,978.50 / $9,511.25
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,696.00 / $25,816.25 / $25,816.25
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27,066.30 / $27,066.30 / $40,762.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,978.44 / $12,978.44 / $12,978.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,086.69 / $2,086.69 / $5,978.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.74 / $853.65 / $4,567.79