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North Carolina 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 $1,698 · 10th–90th $1,514–$6,4570%20%10th90th$1,698Professionalmedian $1,549 · 10th–90th $1,148–$5,4950%20%10th90th$1,549$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,513.56 / $1,621.81
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $4,897.79 / $7,585.78
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,698.24 / $6,025.60
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,317.64 / $8,317.64 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,148.15 / $3,235.94
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25,703.96 / $25,703.96 / $25,703.96
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26,915.35 / $26,915.35 / $40,738.03