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Georgia 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 / $1,745.24 / $1,821.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,549.20 / $1,549.20 / $4,135.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,609.00 / $7,880.75 / $13,044.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,717.50 / $8,913.40 / $14,022.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,891.50 / $7,065.50 / $12,685.39
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,576.35 / $7,609.00 / $9,701.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.74 / $1,138.20 / $6,530.70