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Connecticut 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
$1,005.41 / $1,033.86 / $1,327.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,771.85 / $3,815.10 / $4,836.74
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,819.79 / $8,546.54 / $13,424.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$948.50 / $1,215.59 / $9,537.87