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New Mexico 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 $3,715 · 10th–90th $1,698–$7,0790%10%20%10th90th$3,715Professionalmedian $1,413 · 10th–90th $447–$2,3990%20%10th90th$1,413$500.0$1.0K$2.0K$5.0K

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
$446.68 / $1,412.54 / $2,398.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,466.84 / $4,897.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $8,511.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,715.35 / $7,079.46
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,905.46