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Indiana 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
$1,289.96 / $1,498.63 / $1,612.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,316.82 / $1,549.20 / $2,044.94
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,706.75 / $7,065.50 / $7,609.00
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,435.00 / $6,522.00 / $8,152.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,044.94 / $6,620.11 / $15,862.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.74 / $1,138.20 / $2,084.80