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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

Facilitymedian $6,457 · 10th–90th $1,259–$25,7040%10%20%10th90th$6,457Professionalmedian $1,660 · 10th–90th $1,148–$6,4570%10%10th90th$1,660$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,513.56 / $1,819.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,862.09 / $2,951.21
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,162.28 / $4,073.80 / $9,332.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,489.63 / $13,489.63 / $13,489.63
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $6,025.60 / $7,413.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,025.60 / $9,549.93
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25,703.96 / $25,703.96 / $25,703.96
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26,915.35 / $40,738.03 / $40,738.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $5,495.41 / $8,128.31
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,089.30 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $6,456.54