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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

Facilitymedian $10,233 · 10th–90th $5,129–$25,7040%20%40%10th90th$10,233Professionalmedian $1,479 · 10th–90th $1,148–$6,1660%20%10th90th$1,479$1.0K$2.0K$5.0K$10.0K$20.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,232.93 / $10,232.93 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $1,621.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $6,309.57 / $6,456.54
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,549.93 / $9,549.93 / $9,549.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $7,079.46 / $25,703.96
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $3,311.31 / $26,915.35
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $6,456.54 / $6,456.54
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,888.44 / $11,481.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $6,165.95
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41