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Montana 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 $8,128 · 10th–90th $5,495–$16,5960%10%20%10th90th$8,128Professionalmedian $1,148 · 10th–90th $794–$10,7150%50%10th90th$1,148$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $7,943.28
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $8,128.31 / $16,595.87
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,495.41 / $8,128.31 / $16,595.87
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $12,022.64
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $3,981.07