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Kentucky 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 / $1,327.90 / $1,327.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,316.82 / $1,549.20 / $1,549.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,337.25 / $41,999.58 / $144,778.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,250.25 / $7,609.00 / $100,093.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,522.00 / $6,522.00 / $6,522.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,307.84 / $6,932.38 / $26,196.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.20 / $1,138.20 / $2,086.69