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Hawaii 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
$2,398.83 / $2,398.83 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,456.54 / $6,456.54 / $6,456.54
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $5,754.40 / $5,754.40
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,025.60 / $6,456.54 / $7,585.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $6,456.54