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Illinois 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
$12,717.90 / $12,717.90 / $12,717.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.86 / $9,946.04 / $9,946.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,307.84 / $6,620.11 / $7,931.64
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,978.50 / $9,239.50 / $11,445.77
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,391.60 / $7,989.45 / $8,152.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.74 / $1,138.20 / $2,282.69