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Nebraska 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
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,720.98 / $1,720.98 / $1,720.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,978.50 / $8,467.71 / $8,913.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,522.00 / $6,522.00 / $6,522.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,857.75 / $3,587.10 / $25,816.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.20 / $1,138.20 / $27,066.30
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,733.30 / $6,522.00 / $12,717.90
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,733.30 / $6,522.00 / $13,913.60
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,358.95 / $6,358.95 / $11,087.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,081.29 / $1,138.20 / $3,699.15