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New Jersey 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 $19,498 · 10th–90th $13,804–$218,7760%20%10th90th$19,498Professionalmedian $1,549 · 10th–90th $1,000–$3,8020%10%20%10th90th$1,549$500.0$2.0K$10.0K$50.0K$200.0K

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,513.56 / $1,621.81
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $7,079.46 / $10,000.00
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $19,498.45 / $218,776.16
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $3,801.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$831.76 / $1,148.15 / $3,801.89