go back

Iowa 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
Facility
Modifier
Low / Median / High Price
$9,699.45 / $9,699.45 / $10,573.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,278.28 / $6,245.39 / $6,522.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,511.25 / $9,511.25 / $9,511.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,184.95 / $7,024.74 / $25,816.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.20 / $1,953.91 / $27,066.30
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,157.43 / $7,024.74 / $12,717.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,319.75 / $6,522.00 / $11,196.10
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,435.00 / $5,435.00 / $9,701.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.20 / $1,138.20 / $5,175.59
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,435.00 / $5,435.00 / $5,435.00